MEDICARE: SANTA FE HEALTHCARE, LLC

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	314000000X	Skilled Nursing Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184793291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA FE HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	2309 N. SANTA FE AVE
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90222-2824
Country	:	US
Telephone Number	:	310-639-8111
Fax Number	:	310-868-5955

Provider Business Practice Location Address
First Line	:	2309 N SANTA FE AVE
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90222-2824
Country	:	US
Telephone Number	:	310-639-8111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MRS. JEOUNG HANS LEE
Credential	:
Telephone Number	:	323-225-8804

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	11/18/2013

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