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Organization

EISENBERG VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING

Active
Other names
Eisenberg Village
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARY M FORREST (CHIEF EXECUTIVE OFFICER)
(818) 774-9208
Entity
Organization

Contact information

Practice address
18855 VICTORY BLVD, RESEDA, CA 91335-6445
(818) 774-3000
Mailing address
18855 VICTORY BLVD, RESEDA, CA 91335-6445
(818) 774-3000

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
920000043
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZT08013F
CA
Enumeration date
05/24/2005
Last updated
12/20/2011
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