Provider Demographics
NPI:1114053683
Name:SYLMAR HEALTH AND REHABILITATION CENTER INC.
Entity Type:Organization
Organization Name:SYLMAR HEALTH AND REHABILITATION CENTER INC.
Other - Org Name:SYLMAR HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINTNELL-HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-834-5082
Mailing Address - Street 1:12220 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-6001
Mailing Address - Country:US
Mailing Address - Phone:818-834-5082
Mailing Address - Fax:818-834-5981
Practice Address - Street 1:12220 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-6001
Practice Address - Country:US
Practice Address - Phone:818-834-5082
Practice Address - Fax:818-834-5981
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN STATE HEALTH CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-26
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA920000123314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility