Organization
WASHINGTON ENTERPRISES III, LLC
Active
Other names
St. Andrews Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL RIVERA CHIVI (ADMINISTRATOR)
(323) 731-0861
Entity
Organization
Contact information
Practice address
2300 W. WASHINGTON BLVD., LOS ANGELES, CA 90018-1445
(323) 731-0861
(323) 735-0616
Mailing address
2300 W. WASHINGTON BLVD., LOS ANGELES, CA 90018-1445
(323) 731-0861
(323) 735-0616
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18658G
—
CA
Enumeration date
11/10/2005
Last updated
01/05/2012
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