Organization
MT. RUBIDOUX CONVALESCENT HOSPITAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH PLOTT TYLER J.D. (VICE PRESIDENT OF OPERATIONS)
(323) 655-6960
Entity
Organization
Contact information
Practice address
6401 33RD ST, RIVERSIDE, CA 92509-1404
(951) 681-2200
(951) 681-4402
Mailing address
5455 WILSHIRE BLVD, STE 1925, LOS ANGELES, CA 90036-4201
(323) 655-6960
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05581I
—
CA
Enumeration date
08/03/2005
Last updated
08/22/2020
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