Organization
MIRACLE MILE HEALTHCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CHASE (MANAGER)
(626) 658-7344
Entity
Organization
Contact information
Practice address
1020 S FAIRFAX AVE, LOS ANGELES, CA 90019-4401
(323) 938-2451
Mailing address
107 W LEMON AVE, MONROVIA, CA 91016-2809
(626) 658-7344
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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