# IMPERIAL CREST HEALTHCARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Imperial Crest Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316033087
- **Authorized official:** MR. DAVID FRIEDMAN (MANAGING MEMBER)
- **Authorized official phone:** (213) 389-6900

## Contact information

- **Practice address:** 11834 INGLEWOOD AVE, HAWTHORNE, CA 90250-0107
- **Practice address phone:** (310) 679-1461
- **Practice address fax:** (310) 679-2511
- **Mailing address:** 4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
- **Mailing address phone:** (213) 389-6900
- **Mailing address fax:** (213) 368-8560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 910000054 | CA | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 06/22/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55719F | — | CA |