Innovative Lake Forest Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

PENDING Issued in CA

Legal business name

INNOVATIVE LAKE FOREST OPERATIONS, LLC

Practice address

23442 El Toro Rd
Lake Forest, CA 92630-6979

Phone

(800) 584-8084

NPI assigned

Oct 30, 2007

Organization subpart

No

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

Authorized official

Name

Nick Dobron

Title

Vice President

Phone

(760) 690-5262

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1437338217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1282 PACIFIC OAKS PL",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920292900",
            "telephone_number": "760-690-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23442 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926306979",
            "telephone_number": "800-584-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE LAKE FOREST OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "DOBRON",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "760-690-5262"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Lake Forest, CA
• Providers in Lake Forest, 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 Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.