MEDICARE: B-SPRING VALLEY, 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	090000095	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	:	1780682021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B-SPRING VALLEY, LLC

Provider Business Mailing Address
First Line	:	9009 CAMPO RD
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-1112
Country	:	US
Telephone Number	:	619-460-2711
Fax Number	:	619-460-0451

Provider Business Practice Location Address
First Line	:	9009 CAMPO RD
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-1112
Country	:	US
Telephone Number	:	619-460-2711
Fax Number	:	619-460-0451

Authorized Official
Title or Position	:	CEO
Name	:	MR. SHLOMO RECHNITZ
Credential	:
Telephone Number	:	626-800-1191

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	01/17/2023

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