Organization
MAR VISTA NURSING CENTER LLC
Active
Other names
Mar Vista Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN REISSMAN (CEO/CHAIRMAN)
(310) 574-3733
Entity
Organization
Contact information
Practice address
3966 MARCASEL AVE, LOS ANGELES, CA 90066-4616
(310) 397-2372
(310) 397-2383
Mailing address
5120 W GOLDLEAF CIR STE 400, LOS ANGELES, CA 90056-1297
(323) 596-2145
(323) 596-4645
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
910000077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55726F
—
CA
Enumeration date
03/13/2012
Last updated
03/13/2012
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