Cottonwood Canyon Healthcare Center

LBN: Koa Holdings, Llc
Cottonwood Canyon Healthcare Center is an health care organization with primary practice located at 1391 E Madison Ave , El Cajon CA 92021-8568. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Koa Holdings, Llc can be contacted via phone (619) 444-1107, or through Ballif, Mark via phone (760) 471-0388.

Contact Information

Primary practice address
1391 E Madison Ave El Cajon CA 92021-8568
Phone: (619) 444-1107
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ballif, Mark
Phone: (760) 471-0388

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 090000071 California

Profile Details

NPI number 1013953199
LBN Legal business name Koa Holdings, Llc
DBA Doing business as Cottonwood Canyon Healthcare Center
Authorized official Ballif, Mark
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2006
Last updated Jan 29th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013953199 NPPES
California MEDICAID ZZT05064I

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