OrganizationActive
12882 Shackelford Lane Inc
NPI 1497903868 · Skilled Nursing Facility · Garden Grove, CA
Provider details
- NPI number
- 1497903868
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Rosalie Sanchez, Manager(562) 930-0777
- License
- 060000112 (CA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
12882 Shackelford Ln
Garden Grove, CA 92841-5109
Phone: (714) 638-9470
Fax: (714) 638-4549
Approximate (ZIP-level) locationGet directions
Mailing address
4115 E Broadway
Long Beach, CA 90803-1532
Other names (DBA / former)
- Doing business as
- Garden Grove Conv Hospital
Registry dates
- Enumerated
- 2008-08-28
- Last updated
- 2010-12-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.