PORTOLA GARDENS LLC
NPI: 1215561444
· SAN FRANCISCO, CA 94134
· Assisted Living Facility
· NPI assigned 02/26/2020
$564K
Total Medicaid Paid
Provider Details
| Authorized Official | CIMINO, MARK (LICENSEE) |
| NPI Enumeration Date | 02/26/2020 |
Related Entities
Other providers sharing the same authorized official: CIMINO, MARK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
20 |
$44K |
| 2024 |
226 |
$519K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2031 |
Assisted living; waiver, per diem |
246 |
145 |
$564K |