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Organization
BROADWAY MANOR CARE CENTER LLC
Active
Organization
BROADWAY MANOR CARE CENTER LLC
Active
Other names
BROADWAY MANOR CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
IRA DAVID FRIEDMAN (MANAGER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
605 W BROADWAY, GLENDALE, CA 91204-1007
(818) 246-7174
(818) 246-7635
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(818) 246-7635
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000064
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05670J
—
CA
Enumeration date
11/07/2006
Last updated
09/29/2023
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