Provider Demographics
NPI:1366025496
Name:BEIT SHALOM GROUP LLC.
Entity Type:Organization
Organization Name:BEIT SHALOM GROUP LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-222-7598
Mailing Address - Street 1:1620 S SHERBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4415
Mailing Address - Country:US
Mailing Address - Phone:213-222-7598
Mailing Address - Fax:
Practice Address - Street 1:1620 S SHERBOURNE DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4415
Practice Address - Country:US
Practice Address - Phone:213-222-7598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility