Organization
CENTURY VILLA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI ROLLINS RN,BSN,NHA (VICE-PRESIDENT)
(714) 323-8270
Entity
Organization
Contact information
Practice address
805 W ARROW HWY, GLENDORA, CA 91740-5413
(714) 323-8270
Mailing address
310 CENTINELA AVE., INGLEWOOD, CA 90302
(714) 323-8270
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206190106
OSHPD NUMBER
CA
01
—
555368
MEDICARE PTN
—
05
—
LTC55368H
—
CA
Enumeration date
03/13/2013
Last updated
03/13/2013
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