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General NPI Number Information
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NPI Number | 1639264914
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Entity Type | Organization
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Legal Business Name | CLEAR VIEW SANITARIUM, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/29/2014
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Provider Practice Location Address
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Address Line | 15823 S WESTERN AVE
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City | GARDENA
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State | CA
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Zip | 90247-3703
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Country | US
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Telephone | 310-538-2323
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Fax | 310-538-3509
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Provider Business Mailing Address
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Address Line | 15823 S WESTERN AVE
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City | GARDENA
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State | CA
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Zip | 90247-3703
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Country | US
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Telephone | 310-538-2323
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Fax | 310-538-3509
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. MARK D TOWNS
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Credential | PH.D.
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Telephone | 310-538-2323
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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 | 910000028
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License Number State | CA
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