Organization
MANCHESTER MANOR CONVALESCENT HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELORES J JOHNSON RN RN (OWNER/DIRECTOR OF NURSING)
(323) 753-1789
Entity
Organization
Contact information
Practice address
837 W MANCHESTER AVE, LOS ANGELES, CA 90044-4913
(323) 753-1789
(323) 753-0400
Mailing address
837 W MANCHESTER AVE, LOS ANGELES, CA 90044-4913
(323) 753-1789
(323) 753-0400
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
970000032
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC55273F
LTC PROVIDER NUMBER
CA
Enumeration date
11/15/2005
Last updated
03/31/2016
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