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General NPI Number Information
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NPI Number | 1114901741
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Entity Type | Organization
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Legal Business Name | SOLHEIM LUTHERAN HOME
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2236 MERTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90041-1915
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Country | US
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Telephone | 323-257-7518
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Fax | 323-255-3544
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Provider Business Mailing Address
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Address Line | 2236 MERTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90041-1915
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Country | US
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Telephone | 323-257-7518
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Fax | 323-255-3544
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES GRAUNKE
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Credential | NHA
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Telephone | 323-257-7518
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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 | CA970000049
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License Number State | CA
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