Organization
CALIFORNIA CONVALESCENT CENTER 1 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN BONIFACIO (CORPORATE SECRETARY)
(213) 385-7301
Entity
Organization
Contact information
Practice address
909 S LAKE ST, LOS ANGELES, CA 90006-2113
(213) 385-7301
(213) 385-0539
Mailing address
909 S LAKE ST, LOS ANGELES, CA 90006-2113
(213) 385-7301
(213) 385-0539
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000065
CA
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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