- Enrollment id
- O20110602000189
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1962700195
- Multiple npi flag
- N
- Ccn
- 056437
- Associate id
- 1759568694
- Organization name
- MARJORAM HOLDINGS LLC
- Doing business as name
- CYPRESS RIDGE CARE CENTER
- Incorporation date
- 2011-02-01
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CYPRESS RIDGE CARE CENTER
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 1501 SKYLINE DR
- City
- MONTEREY
- State
- CA
- Zip code
- 939404110