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Organization
IMPERIAL CREST HEALTHCARE CENTER, LLC
Active
Organization
IMPERIAL CREST HEALTHCARE CENTER, LLC
Active
Other names
Imperial Crest Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID FRIEDMAN (MANAGING MEMBER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
11834 INGLEWOOD AVE, HAWTHORNE, CA 90250-0107
(310) 679-1461
(310) 679-2511
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(213) 368-8560
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55719F
—
CA
Enumeration date
10/04/2006
Last updated
06/22/2016
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