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General NPI Number Information
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NPI Number | 1548796626
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Entity Type | Organization
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Legal Business Name | GREEN MEADOW HOMES, INC.
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 2460 W. 229TH STREET
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City | TORRANCE
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State | CA
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Zip | 90501
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Country | US
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Telephone | 424-378-1101
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Fax | 424-378-1102
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Provider Business Mailing Address
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Address Line | 2340 PLAZA DEL AMO SUITE 235
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City | TORRANCE
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State | CA
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Zip | 90501
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Country | US
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Telephone | 310-782-1002
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Fax | 310-782-1003
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Authorized Official
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Title or Position | CEO
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Name | MR. REYNALDO NUNAG LAGMAN
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Credential |
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Telephone | 702-338-8760
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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 |
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