200 Lighthouse, LLC
NPI #1881152031 in Pacific Grove, California
Provider Information
- NPI Number
- 1881152031
- Entity Type
- Organization
- Organization Name
- 200 Lighthouse, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Mar 6, 2019
- Last Updated
- Mar 6, 2019
Practice Location
- Address
- 200 LIGHTHOUSE AVE
- City
- Pacific Grove
- State
- California
- ZIP Code
- 93950-3022
- Phone
- (931) 375-2695
Authorized Official
- Name
- RICHARD MARTIN
- Title
- MANAGER
- Phone
- (619) 402-3044
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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