Healthcare Provider Details

I. General information

NPI: 1518974542
Provider Name (Legal Business Name): B-EAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8625 LAMAR ST
SPRING VALLEY CA
91977-2518
US

IV. Provider business mailing address

8625 LAMAR ST
SPRING VALLEY CA
91977-2518
US

V. Phone/Fax

Practice location:
  • Phone: 619-461-3222
  • Fax: 619-461-3575
Mailing address:
  • Phone: 619-461-3222
  • Fax: 619-461-3575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number090000110
License Number StateCA

VIII. Authorized Official

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