# SOUTH PASADENA CONVALESCENT INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740489459
- **Authorized official:** GUY REGGEV (ADMINISTRATOR)
- **Authorized official phone:** (626) 799-9571

## Contact information

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

## Taxonomy

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

## Other

- **Enumeration date:** 07/12/2007
- **Last updated:** 02/07/2008

## Other identifiers

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