Organization
GREENFIELD CARE CENTER OF SOUTH GATE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JENG H CHEN (OWNER)
(310) 889-9929
Entity
Organization
Contact information
Practice address
8455 STATE ST, SOUTH GATE, CA 90280-2330
(323) 564-7761
Mailing address
1937 PONTIUS AVE, LOS ANGELES, CA 90025-5611
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
940000160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT06217K
—
CA
Enumeration date
09/28/2005
Last updated
03/25/2020
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