Organization
MARY HEALTH OF THE SICK CONVALESCENT AND NURSING HOSPITAL INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI RUPP (ADMINISTRATOR)
(805) 498-3644
Entity
Organization
Contact information
Practice address
2929 THERESA DR, NEWBURY PARK, CA 91320-3136
(805) 498-3644
(805) 498-5112
Mailing address
2929 THERESA DR, NEWBURY PARK, CA 91320-3136
(805) 498-3644
(805) 498-5112
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05022F
—
CA
Enumeration date
07/12/2005
Last updated
08/28/2007
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