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Organization

13075 BLACKBIRD STREET OPCO, LLC

Active
Other names
Alta Gardens Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
AVROHOM TRESS (MANAGER OF BOLD QUAIL 3 OPERATIONS)
(310) 730-4800
Entity
Organization

Contact information

Practice address
13075 BLACKBIRD ST, GARDEN GROVE, CA 92843-2902
(714) 530-6322
Mailing address
9526 W PICO BLVD, LOS ANGELES, CA 90035-1202
(310) 730-4800

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
03/04/2024
Last updated
03/04/2024
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