Healthcare Provider Details

I. General information

NPI: 1831724509
Provider Name (Legal Business Name): ALVARADO TERRACE CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 S ALVARADO ST
LOS ANGELES CA
90006-4110
US

IV. Provider business mailing address

1154 S ALVARADO ST
LOS ANGELES CA
90006-4110
US

V. Phone/Fax

Practice location:
  • Phone: 213-385-1715
  • Fax: 213-385-7802
Mailing address:
  • Phone: 213-385-1715
  • Fax: 213-385-7802

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: MANAGER
Credential:
Phone: 213-385-7802