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General NPI Number Information
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NPI Number | 1003803842
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH CONVALESCENT SERVICES, INC.
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12023 LAKEWOOD BLVD
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City | DOWNEY
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State | CA
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Zip | 90242-2635
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Country | US
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Telephone | 562-869-0978
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Fax | 562-869-5376
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Provider Business Mailing Address
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Address Line | 12023 LAKEWOOD BLVD
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City | DOWNEY
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State | CA
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Zip | 90242-2635
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Country | US
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Telephone | 562-869-0978
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Fax | 562-869-5376
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DANIEL C. ZILAFRO
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Credential | N.H.A.
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Telephone | 562-869-0978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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