Organization
14857 ROSCOE BLVD CORPORATION
Active
Other names
SUN AIR CONVALESCENT HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIE PIACENTI SANCHEZ (MANAGER)
(562) 930-0777
Entity
Organization
Contact information
Practice address
14857 ROSCOE BLVD, PANORAMA CITY, CA 91402-4617
(818) 894-5707
(818) 894-8151
Mailing address
4115 E BROADWAY, LONG BEACH, CA 90803-1532
(562) 930-0777
(562) 930-0728
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000072
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT06137G
—
CA
Enumeration date
09/29/2005
Last updated
12/08/2010
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