Organization
GLEN PARK AT LONG BEACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TILLMAN PINK JR. (PRESIDENT)
(818) 242-9000
Entity
Organization
Contact information
Practice address
1046 E 4TH ST, LONG BEACH, CA 90802-1634
(562) 432-7468
(562) 432-1425
Mailing address
1220 MARIPOSA ST, GLENDALE, CA 91205-3254
(818) 242-9000
(818) 242-3972
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
198602134
CA
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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