Organization
5648 EAST GOTHAM STREET LLC
Active
Other names
BRIARCREST NURSING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE L BOYER (DIRECTOR OF PATIENT ACCOUNTING)
(818) 367-9546
Entity
Organization
Contact information
Practice address
5648 GOTHAM ST, BELL GARDENS, CA 90201-5413
(562) 927-2641
(562) 927-4639
Mailing address
5648 GOTHAM ST, BELL GARDENS, CA 90201-5413
(562) 927-2641
(562) 927-4639
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC70168F
—
CA
05
—
ZZT06220H
—
CA
Enumeration date
09/19/2005
Last updated
08/22/2020
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