Provider Demographics
NPI:1073608600
Name:CLEAR VIEW SANITARIUM, INC.
Entity Type:Organization
Organization Name:CLEAR VIEW SANITARIUM, INC.
Other - Org Name:CLEAR VIEW CONVALESCENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:TOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-538-2323
Mailing Address - Street 1:15823 S. WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247
Mailing Address - Country:US
Mailing Address - Phone:310-538-2323
Mailing Address - Fax:310-538-3509
Practice Address - Street 1:15823 S. WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3788
Practice Address - Country:US
Practice Address - Phone:310-538-2323
Practice Address - Fax:310-538-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA910000027314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555880Medicare Oscar/Certification