Country Villa Park Marino Healthcare Center
LBN: Country Villa Park Marino Healthcare Center, Llc
Country Villa Park Marino Healthcare Center is an health care organization with primary practice located at 2585 E Washington Blvd , Pasadena CA 91107-1446. 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.
Country Villa Park Marino Healthcare Center, Llc can be contacted via phone (626) 463-4105, or through Reissman, Stephen E. via phone (310) 574-3733.
Contact Information
Primary practice address
2585 E Washington Blvd
Pasadena CA 91107-1446
Phone: (626) 463-4105
Fax: (626) 798-5121
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 970000088 | California |
Profile Details
| NPI number | 1811982176 |
|---|---|
| LBN Legal business name | Country Villa Park Marino Healthcare Center, Llc |
| DBA Doing business as | Country Villa Park Marino Healthcare Center |
| Authorized official | Reissman, Stephen E. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Jan 20th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811982176 | NPPES |
| California | MEDICAID | LTC05548F |
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