Healthcare Provider Details

I. General information

NPI: 1174459002
Provider Name (Legal Business Name): FLATBUSH RESIDENCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 WHITE AVE
LONG BEACH CA
90805-1322
US

IV. Provider business mailing address

15002 FLATBUSH AVE
NORWALK CA
90650-5320
US

V. Phone/Fax

Practice location:
  • Phone: 562-470-6077
  • Fax:
Mailing address:
  • Phone: 714-317-4740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: REYOLITO MANIWANG
Title or Position: CEO
Credential:
Phone: 714-317-4740