# COUNTRY VILLA CLAREMONT HEALTHCARE CENTER, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1982698882
- **Authorized official:** MR. STEPHEN E. REISSMAN (PRESIDENT)
- **Authorized official phone:** (310) 574-3733

## Contact information

- **Practice address:** 590 S INDIAN HILL BLVD, CLAREMONT, CA 91711-5212
- **Practice address phone:** (909) 624-4511
- **Practice address fax:** (909) 624-4964
- **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 | 950000053 | CA | Yes |

## Other

- **Enumeration date:** 09/07/2005
- **Last updated:** 01/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05344J | — | CA |