Organization
ICC CONVALESCENT LLC
Active
Other names
IMPERIAL CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
IRA DAVID FRIEDMAN (MANAGER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
11441 VENTURA BLVD, STUDIO CITY, CA 91604-3143
(818) 980-8200
(818) 980-2234
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(818) 762-8339
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05418G
—
CA
Enumeration date
11/08/2006
Last updated
09/29/2023
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