Organization
FIVE STAR QUALITY CARE CA LLC
Active
Parent organization
FIVE STAR QUALITY CARE CA LLC
Other names
Van Nuys Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR QUALITY CARE CA LLC
Authorized official
KATHERINE E. POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 796-8387
Entity
Organization
Contact information
Practice address
6835 HAZELTINE AVE, VAN NUYS, CA 91405-3218
(818) 997-1841
(818) 893-6815
Mailing address
400 CENTRE ST, NEWTON, MA 02458-2094
(617) 796-8387
(617) 796-8375
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000087
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC90037I
—
CA
Enumeration date
05/23/2006
Last updated
03/22/2019
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