Healthcare Provider Details

I. General information

NPI: 1992781561
Provider Name (Legal Business Name): ROYALWOOD CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22520 MAPLE AVE
TORRANCE CA
90505-2705
US

IV. Provider business mailing address

22520 MAPLE AVE
TORRANCE CA
90505-2705
US

V. Phone/Fax

Practice location:
  • Phone: 310-326-9131
  • Fax: 310-539-6377
Mailing address:
  • Phone: 310-326-9131
  • Fax: 310-539-6377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910000092
License Number StateCA

VIII. Authorized Official

Name: MICHAEL T. BERG
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 505-468-4752