Organization
KSM HEALTHCARE, INC.
Active
Other names
KING SOLOMON MANAGEMENT INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CURT HAEDRICH NHA (ADMINISTRATOR)
(818) 242-1183
Entity
Organization
Contact information
Practice address
1400 W GLENOAKS BOULEVARD, GLENDALE, CA 91201-1911
(818) 242-1183
(818) 246-1085
Mailing address
1400 W GLENOAKS BOULEVARD, GLENDALE, CA 91201-1911
(818) 242-1183
(818) 246-1085
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
920000028
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC90085F
—
CA
Enumeration date
04/18/2006
Last updated
11/21/2011
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