Organization
COUNTRY VILLA WESTWOOD, A CA LTD
Active
Other names
Country Villa Westwood Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN E. REISSMAN (MANAGING MEMBER OF GENERAL PARTNER)
(310) 574-3733
Entity
Organization
Contact information
Practice address
12121 SANTA MONICA BLVD, LOS ANGELES, CA 90025-2515
(310) 826-0821
(310) 207-9311
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
910000123
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05060H
—
CA
Enumeration date
09/06/2005
Last updated
03/31/2014
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