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General NPI Number Information
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NPI Number | 1982960209
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Entity Type | Organization
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Legal Business Name | SHERATON HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 9655 SEPULVEDA BLVD
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City | NORTH HILLS
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State | CA
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Zip | 91343-3307
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Country | US
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Telephone | 323-596-2145
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Fax | 323-596-4645
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Provider Business Mailing Address
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Address Line | 5120 W GOLDLEAF CIR STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90056-1297
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Country | US
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Telephone | 310-574-3733
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Fax | 323-596-4645
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Authorized Official
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Title or Position | CEO/CHAIRMAN
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Name | MR. STEPHEN REISSMAN
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Credential |
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Telephone | 310-574-3733
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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 | 920000065
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License Number State | CA
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