MEDICARE: SINAI CONGREGATE LIVING FACILITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility

General Provider Information

NPI Number	:	1063994408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINAI CONGREGATE LIVING FACILITY

Provider Business Mailing Address
First Line	:	1759 WINDERMERE DRIVE
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-5319
Country	:	US
Telephone Number	:	562-888-6568
Fax Number	:	562-239-2022

Provider Business Practice Location Address
First Line	:	1759 WINDERMERE DRIVE
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-5319
Country	:	US
Telephone Number	:	562-888-6568
Fax Number	:	562-239-2022

Authorized Official
Title or Position	:	CEO
Name	:	MS. CHRISTINE HANNA
Credential	:
Telephone Number	:	562-888-6568

Provider Enumeration Date	:	09/01/2018
Last Update Date	:	09/19/2018

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