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General NPI Number Information
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NPI Number | 1083703573
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Entity Type | Organization
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Legal Business Name | NORWALK MEADOWS NURSING CENTER LP
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 10625 LEFFINGWELL RD
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City | NORWALK
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State | CA
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Zip | 90650
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Country | US
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Telephone | 562-864-2541
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Fax | 562-864-2231
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Provider Business Mailing Address
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Address Line | 1141 S BEVERLY DR
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City | LOS ANGELES
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State | CA
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Zip | 90035-1119
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Country | US
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Telephone | 310-286-3074
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JACOB M GRAFF
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Credential |
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Telephone | 310-286-3074
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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 | 940000079
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License Number State | CA
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