Provider Demographics
NPI:1265687644
Name:CENTINELA SKILLED NURSING & WELLNESS CENTRE WEST, LLC
Entity Type:Organization
Organization Name:CENTINELA SKILLED NURSING & WELLNESS CENTRE WEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:RECHNITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-800-1191
Mailing Address - Street 1:950 S FLOWER ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4186
Mailing Address - Country:US
Mailing Address - Phone:310-674-3216
Mailing Address - Fax:
Practice Address - Street 1:950 S FLOWER ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4186
Practice Address - Country:US
Practice Address - Phone:310-674-3216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA910000052314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT06167JMedicaid
CA056167Medicare Oscar/Certification
CAZZT06167JMedicaid