Organization
COUNTRY VILLA PLAZA, A CA LTD. PARTNERSHIP
Active
Other names
Country Villa Plaza Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN E. REISSMAN (PRESIDENT OF GENERAL PARTNER)
(310) 574-3733
Entity
Organization
Contact information
Practice address
1209 HEMLOCK WAY, SANTA ANA, CA 92707-3609
(714) 546-1966
(714) 546-6719
Mailing address
5120 W GOLDLEAF CIR, SUITE 400, LOS ANGELES, CA 90056-1292
(310) 574-3733
(310) 574-1322
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
060000168
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05206K
—
CA
Enumeration date
09/02/2005
Last updated
01/29/2014
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