Evergreen At Fullerton, L.L.C.
Skilled Nursing Facility in Fullerton, CA. Organization (NPI-2).
NPI number1104874239
StatusActive
Last updated in NPPESJan 2, 2014
Details
- NPI
- 1104874239
- Entity type
- Organization (NPI-2)
- Legal business name
- Evergreen At Fullerton, L.L.C.
- Organization subpart
- Yes
- Enumeration date
- May 4, 2006
- Last updated
- Jan 2, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 060000205 | CA | Yes |
Other names
- Fullerton Post Acute Care (Doing Business As)
Practice location
2222 N Harbor BlvdFullerton, CA 92835-2605
Phone 714-992-5701 · Fax 714-526-4884
Mailing address
2222 N Harbor BlvdFullerton, CA 92835-2605
Phone 714-992-5701 · Fax 714-526-4884
Authorized official
Dale L. Patterson
Manager
3608926628
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