# LOS FELIZ HEALTHCARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Country Villa Los Feliz Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033458237
- **Authorized official:** MRS. CHERYL A PETTERSON (VP BUSINESS SERVICES)
- **Authorized official phone:** (323) 596-2145

## Contact information

- **Practice address:** 3002 ROWENA AVE, LOS ANGELES, CA 90039-2005
- **Practice address phone:** (323) 666-1544
- **Practice address fax:** (323) 666-9584
- **Mailing address:** 3002 ROWENA AVE, LOS ANGELES, CA 90039-2005
- **Mailing address phone:** (323) 666-1544
- **Mailing address fax:** (323) 666-9584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 970000041 | CA | Yes |

## Other

- **Enumeration date:** 02/07/2013
- **Last updated:** 02/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT18588J | — | CA |