Healthcare Provider Details

I. General information

NPI: 1750792941
Provider Name (Legal Business Name): VERMONT HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2014
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22035 S VERMONT AVE
TORRANCE CA
90502-2120
US

IV. Provider business mailing address

22035 S VERMONT AVE
TORRANCE CA
90502-2120
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-0812
  • Fax: 310-782-3890
Mailing address:
  • Phone: 310-328-0812
  • Fax: 310-782-3890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MOISE E HENDELES
Title or Position: MEMBER
Credential:
Phone: 323-933-5763