# HYDE PARK CONVALESCENT HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HYDE PARK CONVALESCENT HOSPITAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689733453
- **Authorized official:** MRS. ELAINE M WIESEL (ADMINISTRATOR)
- **Authorized official phone:** (323) 753-1354

## Contact information

- **Practice address:** 6520 WEST BLVD, LOS ANGELES, CA 90043-4311
- **Practice address phone:** (323) 753-1354
- **Practice address fax:** (323) 753-0509
- **Mailing address:** 6520 WEST BLVD, LOS ANGELES, CA 90043-4311
- **Mailing address phone:** (323) 753-1354
- **Mailing address fax:** (323) 753-0509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 910000066 | CA | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 06/08/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05326G | — | CA |