Healthcare Provider Details
I. General information
NPI: 1427457233
Provider Name (Legal Business Name): HACIENDA HEIGHTS HEALTHCARE & WELLNESS CENTRE, LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1311 E DATE ST
SAN BERNARDINO CA
92404-4233
US
IV. Provider business mailing address
5900 WILSHIRE BLVD SUITE 1600
LOS ANGELES CA
90036-5013
US
V. Phone/Fax
- Phone: 909-882-3316
- Fax: 909-882-5126
- Phone: 323-330-6500
- Fax: 866-603-3566
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHLOMO
RECHNITZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 323-634-1940