Provider Demographics
NPI:1427593938
Name:CORONA POST ACUTE LLC
Entity Type:Organization
Organization Name:CORONA POST ACUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:MOSHE
Authorized Official - Last Name:RASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-445-6636
Mailing Address - Street 1:1267 WILLIS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5941
Practice Address - Country:US
Practice Address - Phone:951-736-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility