# CHEVIOT GARDEN LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Country Villa Cheviot Garden Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720073059
- **Authorized official:** MR. STEPHEN E. REISSMAN (PRESIDENT OF CVHS, MANAGER)
- **Authorized official phone:** (310) 574-3733

## Contact information

- **Practice address:** 3533 MOTOR AVE, LOS ANGELES, CA 90034-4806
- **Practice address phone:** (310) 836-8900
- **Practice address fax:** (310) 815-9786
- **Mailing address:** 5120 W GOLDLEAF CIR, SUITE 400, LOS ANGELES, CA 90056-1292
- **Mailing address phone:** (310) 574-3733
- **Mailing address fax:** (310) 574-1322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 910000090 | CA | Yes |

## Other

- **Enumeration date:** 09/13/2005
- **Last updated:** 04/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT06273K | — | CA |