MEDICARE: SANDRA FINEST ASSISTED LIVING 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1881480424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA FINEST ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	4825 GAVIOTA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-1209
Country	:	US
Telephone Number	:	562-230-7104
Fax Number	:

Provider Business Practice Location Address
First Line	:	4825 GAVIOTA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-1209
Country	:	US
Telephone Number	:	562-230-7104
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SANDRA CAIN
Credential	:	N/A
Telephone Number	:	562-230-7104

Provider Enumeration Date	:	04/18/2025
Last Update Date	:	04/22/2025

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