Provider Demographics
NPI:1730977828
Name:MORRO BAY HOLDINGS LLC
Entity type:Organization
Organization Name:MORRO BAY HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:METTE
Authorized Official - Middle Name:K
Authorized Official - Last Name:OCONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-933-1744
Mailing Address - Street 1:701 PALOMAR AIRPORT RD STE 230
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1046
Mailing Address - Country:US
Mailing Address - Phone:760-656-6985
Mailing Address - Fax:
Practice Address - Street 1:4367 CONCORD BLVD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-1145
Practice Address - Country:US
Practice Address - Phone:925-689-7457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility