| NPI | 1477547750 |
|---|---|
| Doing Business As | COUNTRY VILLA HACIENDA HEALTHCARE CENTER |
| Entity Type | Organization |
| Authorized Contact | STEPHEN E. REISSMAN Trustee Of Managing Member 310-574-3733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 240000136) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2014-02-04 |