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NPI Code Detail

MEDICARE: NURSING & REHAB AT HOLMESDALE LLC

MEDICARE: NURSING & REHAB AT HOLMESDALE 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1578001228
Entity Type Code : Organization
Provider Name (Legal Business Name) : NURSING & REHAB AT HOLMESDALE LLC
Provider Business Mailing Address
First Line : 4601 WILSHIRE BLVD
Second Line : SUITE 220
City : LOS ANGELES
State : CA
Zip : 90010-3880
Country : US
Telephone Number : 323-405-3377
Fax Number : 323-900-0285
Provider Business Practice Location Address
First Line : 8033 HOLMES RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-2115
Country : US
Telephone Number : 816-363-6222
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SOLOMON GURWITZ
Credential :
Telephone Number : 323-405-3377
Provider Enumeration Date : 02/02/2017
Last Update Date : 03/08/2017

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