Organization
SRSW LLC
Active
Parent organization
SRSO LLC
Other names
Beacon Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SRSO LLC
Authorized official
SPENCER ROBERT SAMUELIAN (MANAGER)
(949) 445-1000
Entity
Organization
Contact information
Practice address
919 N SUNSET AVE, WEST COVINA, CA 91790-1244
(949) 445-1000
Mailing address
4 S STONINGTON RD, LAGUNA BEACH, CA 92651-6741
(949) 445-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2857712
—
CA
Enumeration date
12/04/2013
Last updated
05/30/2017
About Stedi
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