Provider Demographics
NPI:1821664343
Name:COORDINATED HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:COORDINATED HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:CASSIE
Authorized Official - Last Name:PONTECORVO
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:619-948-6611
Mailing Address - Street 1:1835A S CENTRE CITY PKWY # 513
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6525
Mailing Address - Country:US
Mailing Address - Phone:619-948-6611
Mailing Address - Fax:951-654-9307
Practice Address - Street 1:5353 E YALE AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6902
Practice Address - Country:US
Practice Address - Phone:303-757-1209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COORDINATED HEALTH CENTER , LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility