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Organization
WASHINGTON ENTERPRISES III, LLC
Active
Organization
WASHINGTON ENTERPRISES III, LLC
Active
Other names
St. Andrews Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL RIVERA CHIVI (ADMINISTRATOR)
(323) 731-0861
Entity
Organization
Contact information
Practice address
2300 W. WASHINGTON BLVD., LOS ANGELES, CA 90018-1445
(323) 731-0861
(323) 735-0616
Mailing address
2300 W. WASHINGTON BLVD., LOS ANGELES, CA 90018-1445
(323) 731-0861
(323) 735-0616
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18658G
—
CA
Enumeration date
11/10/2005
Last updated
01/05/2012
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