Healthcare Provider Details

I. General information

NPI: 1710322458
Provider Name (Legal Business Name): LAS VEGAS POST ACUTE & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N PUENTE ST
BREA CA
92821-2804
US

IV. Provider business mailing address

530 N PUENTE ST
BREA CA
92821-2804
US

V. Phone/Fax

Practice location:
  • Phone: 310-699-4518
  • Fax: 714-256-2003
Mailing address:
  • Phone: 310-699-4518
  • Fax: 714-256-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MATHESON CHAMBERS
Title or Position: PRESIDENT
Credential:
Phone: 310-699-4518