Lifehouse San Diego Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

PENDING APPROVAL Issued in CA

Legal business name

LIFEHOUSE SAN DIEGO OPERATIONS, LLC

Doing business as

San Diego Healthcare Center

Practice address

2828 Meadow Lark Dr
San Diego, CA 92123-2710

Phone

(858) 277-6460

NPI assigned

Dec 3, 2007

Last updated

Jan 17, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

LIFEHOUSE HEALTH SERVICES, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Clark

Title

Ceo

Phone

(310) 337-1929

Specialties & licenses 1

Addresses

Other names 1

• San Diego Healthcare Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1003098906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE POINTE",
            "address_2": "SUITE 100",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307690",
            "telephone_number": "310-337-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 MEADOW LARK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232710",
            "telephone_number": "858-277-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEHOUSE SAN DIEGO OPERATIONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEHOUSE HEALTH SERVICES, LLC",
        "enumeration_date": "2007-12-03",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-337-1929"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "PENDING APPROVAL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lifemark Solutions LLC
• Lifeologie San Diego
• Lifepath Therapy

• Skilled Nursing Facility in San Diego, CA
• Providers in San Diego, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.