Provider Demographics
NPI:1326473877
Name:PACIFICA L 44 LLC
Entity Type:Organization
Organization Name:PACIFICA L 44 LLC
Other - Org Name:PACIFICA SENIOR LIVING COEUR D'ALENE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ISRANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-296-9000
Mailing Address - Street 1:1775 HANCOCK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2034
Mailing Address - Country:US
Mailing Address - Phone:619-296-9000
Mailing Address - Fax:
Practice Address - Street 1:840 E DALTON AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-9338
Practice Address - Country:US
Practice Address - Phone:208-665-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility