MEDICARE: VERNON HEALTHCARE CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	970000025	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447438999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERNON HEALTHCARE CENTER, LLC

Provider Business Mailing Address
First Line	:	1037 W VERNON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-2415
Country	:	US
Telephone Number	:	323-232-4895
Fax Number	:	323-232-3096

Provider Business Practice Location Address
First Line	:	1037 W VERNON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-2415
Country	:	US
Telephone Number	:	323-232-4895
Fax Number	:	323-232-3096

Authorized Official
Title or Position	:	MANAGER
Name	:	SHLOMO RECHNITZ
Credential	:
Telephone Number	:	626-800-1191

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	10/19/2022

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