Provider Demographics
NPI:1013045475
Name:SABU ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SABU ENTERPRISES, INC.
Other - Org Name:IDLE ACRE SANITARIUM & CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-443-1351
Mailing Address - Street 1:5044 BUFFINGTON RD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-1466
Mailing Address - Country:US
Mailing Address - Phone:626-443-1351
Mailing Address - Fax:
Practice Address - Street 1:5044 BUFFINGTON RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-1466
Practice Address - Country:US
Practice Address - Phone:626-443-1351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05629FMedicaid