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Organization
MAR VISTA NURSING CENTER LLC
Active
Organization
MAR VISTA NURSING CENTER LLC
Active
Other names
Mar Vista Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN REISSMAN (CEO/CHAIRMAN)
(310) 574-3733
Entity
Organization
Contact information
Practice address
3966 MARCASEL AVE, LOS ANGELES, CA 90066-4616
(310) 397-2372
(310) 397-2383
Mailing address
5120 W GOLDLEAF CIR STE 400, LOS ANGELES, CA 90056-1297
(323) 596-2145
(323) 596-4645
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55726F
—
CA
Enumeration date
03/13/2012
Last updated
03/13/2012
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