# INTERCOMMUNITY CARE CENTERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Intercommunity Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659424745
- **Authorized official:** RUSSELL BOYDSTON (ADMINISTRATOR)
- **Authorized official phone:** (562) 427-8915

## Contact information

- **Practice address:** 2626 GRAND AVE, LONG BEACH, CA 90815-1707
- **Practice address phone:** (562) 427-8915
- **Practice address fax:** (562) 427-2348
- **Mailing address:** 2626 GRAND AVE, LONG BEACH, CA 90815-1707
- **Mailing address phone:** (562) 427-8915
- **Mailing address fax:** (562) 427-2348

## Taxonomy

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

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT18608H | — | CA |