Organization
COVENANT CARE LONG BEACH, INC.
Active
Other names
Catered Manor Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
(949) 349-1200
Entity
Organization
Contact information
Practice address
4010 VIRGINIA ROAD, LONG BEACH, CA 90807-2627
(562) 426-0394
(562) 424-1529
Mailing address
120 VANTIS DR STE 200, ALISO VIEJO, CA 92656-2677
(949) 349-1200
(949) 349-1122
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
940000049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT06150J
—
CA
Enumeration date
10/06/2005
Last updated
12/10/2024
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