Organization
BROADWAY MANOR CARE CENTER LLC
Active
Other names
BROADWAY MANOR CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
IRA DAVID FRIEDMAN (MANAGER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
605 W BROADWAY, GLENDALE, CA 91204-1007
(818) 246-7174
(818) 246-7635
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(818) 246-7635
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000064
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05670J
—
CA
Enumeration date
11/07/2006
Last updated
09/29/2023
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