Broadway Healthcare Center

LBN: Ag San Gabriel, Llc
Broadway Healthcare Center is an health care organization with primary practice located at 112 East Broadway , San Gabriel CA 91776. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Ag San Gabriel, Llc can be contacted via phone (626) 285-2165, or through Wintner, Jacob via phone (323) 651-1808.

Contact Information

Primary practice address
112 East Broadway San Gabriel CA 91776
Fax: (626) 287-4061
Website:
Authorized official contact:
Name: Wintner, Jacob

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 950000016 California

Profile Details

NPI number 1477547024
LBN Legal business name Ag San Gabriel, Llc
DBA Doing business as Broadway Healthcare Center
Authorized official Wintner, Jacob
Entity Organization
Organization subpart 1 No
Enumeration date Sep 8th, 2005
Last updated Jul 21st, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477547024 NPPES
California MEDICAID ZZT05592I

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