- Enrollment id
- O20210218001996
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952936395
- Multiple npi flag
- N
- Ccn
- 555748
- Associate id
- 2062827348
- Organization name
- ASMB, LLC
- Doing business as name
- BERKLEY EAST HEALTHCARE CENTER
- Incorporation date
- 2019-05-24
- Incorporation state
- CA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BERKLEY EAST HEALTHCARE CENTER
- Affiliation entity name
- ASPEN SKILLED HEALTHCARE
- Affiliation entity id
- 50
- Address line 1
- 2021 ARIZONA AVE
- City
- SANTA MONICA
- State
- CA
- Zip code
- 904041335