Organization
BROADWATER COMMUNITY CARE CENTER, LLC
Active
Parent organization
PARKSTONE HOLDINGS, LLC
Other names
Community Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARKSTONE HOLDINGS, LLC
Authorized official
MR. DOUG EASTON (MANAGING MEMBER)
(702) 308-7191
Entity
Organization
Contact information
Practice address
2335 MOUNTAIN AVE, DUARTE, CA 91010-3559
(626) 357-3207
(626) 303-1113
Mailing address
2335 MOUNTAIN AVE, DUARTE, CA 91010-3559
(626) 357-3207
(626) 303-1113
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
950000051
CA
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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