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General NPI Number Information
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NPI Number | 1104286053
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Entity Type | Organization
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Legal Business Name | STR LP
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 3753 SADDLEBACK DR
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City | PALMDALE
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State | CA
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Zip | 93550-8519
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Country | US
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Telephone | 661-526-5612
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Fax | 661-526-5103
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Provider Business Mailing Address
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Address Line | 5418 SADRING AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-4146
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Country | US
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Telephone | 818-704-0081
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Fax | 818-301-1904
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Authorized Official
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Title or Position | GP
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Name | MR. SHLOMO ELKAYAM
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Credential |
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Telephone | 818-652-6558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 550003406
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License Number State | CA
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