# AGVA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kei-Ai South Bay Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639548449
- **Authorized official:** MR. JEFFREY BRADSHAW (MANAGER)
- **Authorized official phone:** (949) 347-7100

## Contact information

- **Practice address:** 15115 S VERMONT AVE, GARDENA, CA 90247-4101
- **Practice address phone:** (310) 532-0700
- **Practice address fax:** (310) 532-0001
- **Mailing address:** 15115 S VERMONT AVE, GARDENA, CA 90247-4101
- **Mailing address phone:** (310) 532-0700
- **Mailing address fax:** (310) 532-0001

## Taxonomy

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

## Other

- **Enumeration date:** 09/22/2015
- **Last updated:** 11/23/2015