Basic Information
Provider Information
NPI: 1356746606
EntityType: 2
ReplacementNPI:  
OrganizationName: COLLEGE OPERATIONS, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: DINUBA REHABILITATIONS & NURSING
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 114 PACIFICA
Address2: SUITE 230
City: IRVINE
State: CA
PostalCode: 92618
CountryCode: US
TelephoneNumber: 5595913300
FaxNumber: 5595910705
Practice Location
Address1: 1730 S COLLEGE AVE
Address2:  
City: DINUBA
State: CA
PostalCode: 936182812
CountryCode: US
TelephoneNumber: 5595913300
FaxNumber: 5595910705
Other Information
ProviderEnumerationDate: 10/29/2014
LastUpdateDate: 01/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BRUCE
AuthorizedOfficialFirstName: LELEAND
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EXECUTIVE VICE PRESIDENT
AuthorizedOfficialTelephone: 9492202000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X CAY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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