Provider Demographics
NPI:1376043372
Name:THE GARDENS OF EL MONTE LLC
Entity Type:Organization
Organization Name:THE GARDENS OF EL MONTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-843-4843
Mailing Address - Street 1:4115 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-1532
Mailing Address - Country:US
Mailing Address - Phone:562-930-0777
Mailing Address - Fax:562-344-4771
Practice Address - Street 1:5044 BUFFINGTON RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-1466
Practice Address - Country:US
Practice Address - Phone:626-443-1351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility