- Enrollment id
- O20120820000892
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1891056347
- Multiple npi flag
- N
- Ccn
- 055664
- Associate id
- 7113174525
- Organization name
- YORK HEALTHCARE & WELLNESS CENTRE LP
- Doing business as name
- ROCKPORT HEALTHCARE SERVICES
- Organization type structure
- PARTNERSHIP
- Proprietary nonprofit
- P
- Nursing home provider name
- YORK HEALTHCARE & WELLNESS CENTRE
- Affiliation entity name
- CORPORATE INTERFACE SERVICES
- Affiliation entity id
- 863
- Address line 1
- 6071 YORK BLVD
- City
- LOS ANGELES
- State
- CA
- Zip code
- 900423503