Provider Demographics
NPI:1205826906
Name:QUALITY LONG-TERM CARE INC.
Entity Type:Organization
Organization Name:QUALITY LONG-TERM CARE INC.
Other - Org Name:PINERIDGE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAVLOW
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR OWNER
Authorized Official - Phone:818-361-0191
Mailing Address - Street 1:14122 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4712
Mailing Address - Country:US
Mailing Address - Phone:818-361-0191
Mailing Address - Fax:818-387-1192
Practice Address - Street 1:14122 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4712
Practice Address - Country:US
Practice Address - Phone:818-361-0191
Practice Address - Fax:818-387-1192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAZZT06382L314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========Medicaid
CA=========Medicaid