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Organization
13075 BLACKBIRD STREET OPCO, LLC
Active
Organization
13075 BLACKBIRD STREET OPCO, LLC
Active
Other names
Alta Gardens Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
AVROHOM TRESS (MANAGER OF BOLD QUAIL 3 OPERATIONS)
(310) 730-4800
Entity
Organization
Contact information
Practice address
13075 BLACKBIRD ST, GARDEN GROVE, CA 92843-2902
(714) 530-6322
Mailing address
9526 W PICO BLVD, LOS ANGELES, CA 90035-1202
(310) 730-4800
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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