- Enrollment id
- O20170920001819
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1942722202
- Multiple npi flag
- N
- Ccn
- 555356
- Associate id
- 5294009874
- Organization name
- HONOLUA BAY HOLDINGS LLC
- Doing business as name
- QUARTZ HILL POST ACUTE
- Incorporation date
- 2017-06-27
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- QUARTZ HILL POST ACUTE
- Affiliation entity name
- WEST HARBOR HEALTHCARE
- Affiliation entity id
- 596
- Address line 1
- 2120 BENTON DR
- City
- REDDING
- State
- CA
- Zip code
- 960032151