Healthcare Provider Details

I. General information

NPI: 1326874546
Provider Name (Legal Business Name): MANCHESTER HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 W MANCHESTER AVE
LOS ANGELES CA
90044-4913
US

IV. Provider business mailing address

7162 BEVERLY BLVD # 565
LOS ANGELES CA
90036-2547
US

V. Phone/Fax

Practice location:
  • Phone: 610-457-9593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: AARON MAYER
Title or Position: PRINCIPLE
Credential:
Phone: 323-422-6003