Organization
VILLA ELENA CONVALESCENT HOSPITAL INC
Active
Other names
Villa Elena Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES B. KILIAN (CHIEF FINANCIAL OFFICER)
(909) 796-2595
Entity
Organization
Contact information
Practice address
13226 STUDEBAKER RD, NORWALK, CA 90650-2532
(562) 868-0591
(562) 929-2185
Mailing address
PO BOX 3000, LOMA LINDA, CA 92354-9000
(909) 796-2595
(909) 796-8797
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
940000172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
940000172
STATE LICENSE NUMBER
CA
05
—
ZZT06032F
—
CA
Enumeration date
02/09/2006
Last updated
11/30/2016
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