Healthcare Provider Details

I. General information

NPI: 1801201843
Provider Name (Legal Business Name): ACSB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2014
Last Update Date: 06/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5240 SEPULVEDA BLVD
CULVER CITY CA
90230-5214
US

IV. Provider business mailing address

5240 SEPULVEDA BLVD
CULVER CITY CA
90230-5214
US

V. Phone/Fax

Practice location:
  • Phone: 310-391-7266
  • Fax: 310-391-4998
Mailing address:
  • Phone: 310-391-7266
  • Fax: 310-391-4998

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: MR. JEFFREY J BRADSHAW
Title or Position: MANAGER
Credential:
Phone: 949-347-7100