# SOUTH PASADENA REHABILITATION CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MIssion Grove Healthcare & Wellness Centre
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699780064
- **Authorized official:** MR. GUY REGGEV (MEMBER)
- **Authorized official phone:** (626) 799-9571

## Contact information

- **Practice address:** 904 MISSION ST, SOUTH PASADENA, CA 91030-3144
- **Practice address phone:** (626) 799-9571
- **Practice address fax:** (626) 799-2734
- **Mailing address:** 904 MISSION ST, SOUTH PASADENA, CA 91030-3144
- **Mailing address phone:** (626) 799-9571
- **Mailing address fax:** (626) 799-2734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 970000038 | CA | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 03/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05931G | — | CA |