Organization
GARDEN CREST CONVALESCENT HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL H BARRON (ADMINISTRATOR)
(323) 663-8281
Entity
Organization
Contact information
Practice address
909 LUCILE AVE, LOS ANGELES, CA 90026-1511
(323) 663-8281
(323) 666-0095
Mailing address
909 LUCILE AVE, LOS ANGELES, CA 90026-1511
(323) 663-8281
(323) 666-0095
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
970000031
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0691270001
CIGNA-DMERC
CA
05
—
LTC05161F
—
CA
Enumeration date
10/11/2005
Last updated
12/29/2009
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