Organization
CALFORNIA CARE CENTERS, INC.
Active
Other names
The Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS G WILDER (LICENSEE)
(310) 560-2701
Entity
Organization
Contact information
Practice address
1905 PICO BLVD, SANTA MONICA, CA 90405-1627
(310) 450-1748
Mailing address
1905 PICO BLVD, SANTA MONICA, CA 90405-1627
(310) 450-1748
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191603749
ADULT RESIDENTIAL
CA
Enumeration date
04/28/2023
Last updated
04/28/2023
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