MEDICARE: GR8 CARE, INC.

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	950000012	CA

General Provider Information

NPI Number	:	1770564114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GR8 CARE, INC.

Provider Business Mailing Address
First Line	:	14518 LOS ANGELES ST
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-2699
Country	:	US
Telephone Number	:	626-337-7229
Fax Number	:	626-337-9456

Provider Business Practice Location Address
First Line	:	14518 LOS ANGELES ST
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-2699
Country	:	US
Telephone Number	:	626-337-7229
Fax Number	:	626-337-9456

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. CYRIL E PEREZ
Credential	:	NHA
Telephone Number	:	626-337-7229

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	04/03/2025

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