Healthcare Provider Details

I. General information

NPI: 1316019482
Provider Name (Legal Business Name): ARTESIA HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 W ALAMEDA AVENUE ALAMEDA CARE CENTER
BURBANK CA
91506-2801
US

IV. Provider business mailing address

4032 WILSHIRE BLVD FL 6
LOS ANGELES CA
90010-3425
US

V. Phone/Fax

Practice location:
  • Phone: 818-843-1771
  • Fax:
Mailing address:
  • Phone: 213-389-6900
  • Fax: 213-368-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number920000010
License Number StateCA

VIII. Authorized Official

Name: MR. DAVID FRIEDMAN
Title or Position: PRESIDENT
Credential:
Phone: 213-389-6900