Marycrest Manor

LBN: Marycrest Manor
Marycrest Manor is an health care organization with primary practice located at 10664 Saint James Drive , Culver City CA 90230. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Marycrest Manor can be contacted via phone (310) 838-2778, or through Maldonado, Veronica via phone (310) 838-2778.

Contact Information

Primary practice address
10664 Saint James Drive Culver City CA 90230
Phone: (310) 838-2778
Fax: (310) 838-9647
Website:
Map and Directions
Authorized official contact:
Name: Maldonado, Veronica
Phone: (310) 838-2778

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 910000079 California
Suppliers / Nursing Facility Supplies 332BN1400X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X

Profile Details

NPI number 1932193984
LBN Legal business name Marycrest Manor
DBA Doing business as
Authorized official Maldonado, Veronica
Entity Organization
Organization subpart 1 No
Enumeration date Sep 6th, 2005
Last updated Dec 18th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932193984 NPPES
California MEDICAID ZZT05196F

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