# PAVILION HEALTHCARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pavilion Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790041010
- **Authorized official:** MR. STEPHEN REISSMAN (CEO/CHAIRMAN)
- **Authorized official phone:** (310) 574-3733

## Contact information

- **Practice address:** 5916 W PICO BLVD, LOS ANGELES, CA 90035-2615
- **Practice address phone:** (323) 939-3184
- **Practice address fax:** (323) 939-1966
- **Mailing address:** 5120 W GOLDLEAF CIR STE 400, LOS ANGELES, CA 90056-1297
- **Mailing address phone:** (323) 596-2145
- **Mailing address fax:** (323) 596-4645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 910000145 | CA | Yes |

## Other

- **Enumeration date:** 04/11/2012
- **Last updated:** 04/11/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05160G | — | CA |