# GARDEN GROVE CONVALESCENT HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GARDEN GROVE CONVALESCENT HOSPITAL & GUEST HOME
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295722809
- **Authorized official:** MR. JOHN HENRY SY (VP OF REVENUE MANAGEMENT)
- **Authorized official phone:** (562) 930-0777

## Contact information

- **Practice address:** 12882 SHACKELFORD LN, GARDEN GROVE, CA 92841-5109
- **Practice address phone:** (714) 638-9470
- **Practice address fax:** (714) 638-4549
- **Mailing address:** 4115 E BROADWAY, LONG BEACH, CA 90803-1532
- **Mailing address phone:** (562) 930-0777
- **Mailing address fax:** (562) 930-0728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060000112 | CA | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 05/28/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT06145H | — | CA |