| NPI | 1093149072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIA VITTE Administrator 310-272-6666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 251J00000X Nursing Care |
| 311Z00000X Custodial Care Facility | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2017-12-12 |