Healthcare Provider Details

I. General information

NPI: 1710072558
Provider Name (Legal Business Name): TORRANCE CARE CENTER WEST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 TORRANCE BLVD
TORRANCE CA
90503-4401
US

IV. Provider business mailing address

4333 TORRANCE BLVD
TORRANCE CA
90503-4401
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-4561
  • Fax: 310-793-7631
Mailing address:
  • Phone: 310-370-4561
  • Fax: 310-793-7631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000121
License Number StateCA

VIII. Authorized Official

Name: MS. VICKI P ROLLINS
Title or Position: PRESIDENT
Credential: RN
Phone: 310-370-4561