Organization
GREEN ACRES LODGE LLC
Active
Other names
Green Acres Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
IRA DAVID FRIEDMAN (MANAGER)
(213) 389-6900
Entity
Organization
Contact information
Practice address
8101 HILL DR, ROSEMEAD, CA 91770-4128
(626) 280-2293
(626) 280-5685
Mailing address
4032 WILSHIRE BLVD FL 6, LOS ANGELES, CA 90010-3425
(213) 389-6900
(626) 280-5685
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
950000052
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT18146K
—
CA
Enumeration date
10/17/2006
Last updated
09/29/2023
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