Provider Demographics
NPI:1306832159
Name:THE SISTERS OF NAZARETH OF LOS ANGELES
Entity Type:Organization
Organization Name:THE SISTERS OF NAZARETH OF LOS ANGELES
Other - Org Name:NAZARETH HOUSE - LOS ANGELES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-839-2361
Mailing Address - Street 1:3333 MANNING AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4804
Mailing Address - Country:US
Mailing Address - Phone:310-839-2361
Mailing Address - Fax:310-839-4204
Practice Address - Street 1:3333 MANNING AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4804
Practice Address - Country:US
Practice Address - Phone:310-839-2361
Practice Address - Fax:310-839-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility