Healthcare Provider Details

I. General information

NPI: 1770564114
Provider Name (Legal Business Name): GR8 CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 04/03/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14518 LOS ANGELES ST
BALDWIN PARK CA
91706-2699
US

IV. Provider business mailing address

14518 LOS ANGELES ST
BALDWIN PARK CA
91706-2699
US

V. Phone/Fax

Practice location:
  • Phone: 626-337-7229
  • Fax: 626-337-9456
Mailing address:
  • Phone: 626-337-7229
  • Fax: 626-337-9456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number950000012
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. CYRIL E PEREZ
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 626-337-7229