Healthcare Provider Details

I. General information

NPI: 1184793291
Provider Name (Legal Business Name): SANTA FE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 11/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 N SANTA FE AVE
COMPTON CA
90222-2824
US

IV. Provider business mailing address

2309 N. SANTA FE AVE
COMPTON CA
90222-2824
US

V. Phone/Fax

Practice location:
  • Phone: 310-639-8111
  • Fax:
Mailing address:
  • Phone: 310-639-8111
  • Fax: 310-868-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JEOUNG HANS LEE
Title or Position: PRESIDENT CEO
Credential:
Phone: 323-225-8804