# BROADWATER COMMUNITY CARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PARKSTONE HOLDINGS, LLC
- **Other names:** Community Care Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639344898
- **Legal business name:** PARKSTONE HOLDINGS, LLC
- **Authorized official:** MR. DOUG EASTON (MANAGING MEMBER)
- **Authorized official phone:** (702) 308-7191

## Contact information

- **Practice address:** 2335 MOUNTAIN AVE, DUARTE, CA 91010-3559
- **Practice address phone:** (626) 357-3207
- **Practice address fax:** (626) 303-1113
- **Mailing address:** 2335 MOUNTAIN AVE, DUARTE, CA 91010-3559
- **Mailing address phone:** (626) 357-3207
- **Mailing address fax:** (626) 303-1113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 950000051 | CA | Yes |

## Other

- **Enumeration date:** 04/28/2008
- **Last updated:** 04/28/2008