Organization
JAPANESE HOME FOR THE AGED
Active
Other names
Keiro Intermediate Care Facility
Organization subpart
No
Provider details
NPI number
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) 980-7530
(323) 263-2721
Mailing address
325 S BOYLE AVE, LOS ANGELES, CA 90033-3812
(323) 980-7530
(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
05/20/2014
Last updated
05/20/2014
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