- Enrollment id
- O20210908000948
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1043983505
- Multiple npi flag
- N
- Ccn
- 555700
- Associate id
- 9931505567
- Organization name
- BEVERLY HILLS REHABILITATION CENTRE LLC
- Doing business as name
- BEVERLY HILLS REHABILITATION CENTRE
- Incorporation date
- 2021-06-14
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BEVERLY HILLS REHABILITATION CENTRE
- Affiliation entity name
- PACS GROUP
- Affiliation entity id
- 690
- Address line 1
- 580 S SAN VICENTE BLVD
- City
- LOS ANGELES
- State
- CA
- Zip code
- 900484621