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General NPI Number Information
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NPI Number | 1629241120
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Entity Type | Organization
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Legal Business Name | GREENFIELD CARE CENTER OF GARDENA
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 16530 S BROADWAY ST
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City | GARDENA
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State | CA
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Zip | 90248-2714
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Country | US
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Telephone | 310-329-9929
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Fax | 310-329-1024
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Provider Business Mailing Address
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Address Line | 1937 PONTIUS AVE
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City | LOS ANGELES
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State | CA
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Zip | 90025-5611
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Country | US
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Telephone | 310-889-9929
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Fax | 310-889-9939
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENQ HORNG CHEN
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Credential |
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Telephone | 310-889-9929
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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 | 910000007
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License Number State | CA
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