MEDICARE: AYER LAR HEALTH CARE CENTER

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	:	1962510735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AYER LAR HEALTH CARE CENTER

Provider Business Mailing Address
First Line	:	16530 S BROADWAY ST
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-2714
Country	:	US
Telephone Number	:	310-889-9929
Fax Number	:	310-889-9939

Provider Business Practice Location Address
First Line	:	16530 S BROADWAY STREET
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-2714
Country	:	US
Telephone Number	:	310-329-9929
Fax Number	:	310-329-1024

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LEE AYERS
Credential	:
Telephone Number	:	310-889-9929

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	04/02/2008

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Directions to “AYER LAR HEALTH CARE CENTER ” Practice Location

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