# EMMANUEL HEALTHCARE CENTER PINECREST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366424889
- **Authorized official:** MRS. WENDA L DAGENAIS LIC ADMINISTRATOR (ADMINISTRATOR)
- **Authorized official phone:** (323) 560-0720

## Contact information

- **Practice address:** 6025 PINE AVE, MAYWOOD, CA 90270-3108
- **Practice address phone:** (323) 560-0720
- **Practice address fax:** (323) 773-7872
- **Mailing address:** 6025 PINE AVE, MAYWOOD, CA 90270-3108
- **Mailing address phone:** (323) 560-0720
- **Mailing address fax:** (323) 773-7872

## Taxonomy

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

## Other

- **Enumeration date:** 11/18/2005
- **Last updated:** 08/22/2020