Organization
JAPANESE HOME FOR THE AGED
Active
Parent organization
KEIRO SENIOR HEALTHCARE
Other names
Keiro Intermediate Care Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEIRO SENIOR HEALTHCARE
Authorized official
MR. SHAWN MIYAKE (PRESIDENT AND CEO)
(323) 980-7500
Entity
Organization
Contact information
Practice address
325 S BOYLE AVE, LOS ANGELES, CA 90033-3812
(323) 263-9655
(323) 263-2721
Mailing address
325 S BOYLE AVE, LOS ANGELES, CA 90033-3812
(323) 263-9655
(323) 263-2721
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
970000039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC90079F
—
CA
Enumeration date
09/22/2006
Last updated
02/24/2015
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