Healthcare Provider Details

I. General information

NPI: 1215912910
Provider Name (Legal Business Name): DEL AMO GARDENS CONVALESCENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22419 KENT AVE
TORRANCE CA
90505-2303
US

IV. Provider business mailing address

22419 KENT AVE
TORRANCE CA
90505-2303
US

V. Phone/Fax

Practice location:
  • Phone: 310-378-4233
  • Fax: 310-378-1724
Mailing address:
  • Phone: 310-378-4233
  • Fax: 310-378-1724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000039
License Number StateCA

VIII. Authorized Official

Name: TAMMY MORA
Title or Position: ASSOCIATE DIRECTOR OF PT ACCOUNTING
Credential:
Phone: 562-576-1284