Healthcare Provider Details

I. General information

NPI: 1003803842
Provider Name (Legal Business Name): MENTAL HEALTH CONVALESCENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12023 LAKEWOOD BLVD
DOWNEY CA
90242-2635
US

IV. Provider business mailing address

12023 LAKEWOOD BLVD
DOWNEY CA
90242-2635
US

V. Phone/Fax

Practice location:
  • Phone: 562-869-0978
  • Fax: 562-869-5376
Mailing address:
  • Phone: 562-869-0978
  • Fax: 562-869-5376

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: MR. DANIEL C. ZILAFRO
Title or Position: ADMINISTRATOR
Credential: N.H.A.
Phone: 562-869-0978