- Enrollment id
- O20110503000808
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1376840074
- Multiple npi flag
- N
- Ccn
- 555816
- Associate id
- 1456536630
- Organization name
- LAWNDALE HEALTHCARE & WELLNESS CENTRE, LLC
- Doing business as name
- ROCKPORT HEALTHCARE SERVICES
- Incorporation date
- 2010-12-03
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LAWNDALE HEALTHCARE & WELLNESS CENTRE LLC
- Address line 1
- 15100 PRAIRIE AVE
- City
- LAWNDALE
- State
- CA
- Zip code
- 902602209