Basic Information
| Provider Information | |||||||||
| NPI: | 1053345660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GENERATIONS HEALTHCARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 HUTTON CENTRE DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927078762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142415600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20371 IRVINE AVE | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927075651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142415600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 09/23/2019 | ||||||||
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| AuthorizedOfficialLastName: | MASTROCOLA | ||||||||
| AuthorizedOfficialFirstName: | LOIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7142415600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.