Healthcare Provider Details

I. General information

NPI: 1780682021
Provider Name (Legal Business Name): B-SPRING VALLEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9009 CAMPO RD
SPRING VALLEY CA
91977-1112
US

IV. Provider business mailing address

9009 CAMPO RD
SPRING VALLEY CA
91977-1112
US

V. Phone/Fax

Practice location:
  • Phone: 619-460-2711
  • Fax: 619-460-0451
Mailing address:
  • Phone: 619-460-2711
  • Fax: 619-460-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number090000095
License Number StateCA

VIII. Authorized Official

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