Healthcare Provider Details

I. General information

NPI: 1447438999
Provider Name (Legal Business Name): VERNON HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 W VERNON AVE
LOS ANGELES CA
90037-2415
US

IV. Provider business mailing address

1037 W VERNON AVE
LOS ANGELES CA
90037-2415
US

V. Phone/Fax

Practice location:
  • Phone: 323-232-4895
  • Fax: 323-232-3096
Mailing address:
  • Phone: 323-232-4895
  • Fax: 323-232-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number970000025
License Number StateCA

VIII. Authorized Official

Name: SHLOMO RECHNITZ
Title or Position: MANAGER
Credential:
Phone: 626-800-1191