Healthcare Provider Details

I. General information

NPI: 1588660369
Provider Name (Legal Business Name): FAMILY HEALTH & HOUSING FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22617 S VERMONT AVE
TORRANCE CA
90502-2595
US

IV. Provider business mailing address

22617 S VERMONT AVE
TORRANCE CA
90502-2550
US

V. Phone/Fax

Practice location:
  • Phone: 310-320-4130
  • Fax: 310-212-3232
Mailing address:
  • Phone: 310-320-4130
  • Fax: 310-212-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000106
License Number StateCA

VIII. Authorized Official

Name: MR. MAXIM BRODSKY
Title or Position: ADMINISTRATOR
Credential:
Phone: 310-320-4130