Provider Demographics
NPI:1497941595
Name:MILWOOD HEALTHCARE, INC
Entity Type:Organization
Organization Name:MILWOOD HEALTHCARE, INC
Other - Org Name:MAYWOOD ACRES HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALGER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRION
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:626-274-4345
Mailing Address - Street 1:2641 S C ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4502
Mailing Address - Country:US
Mailing Address - Phone:805-487-7840
Mailing Address - Fax:805-487-7247
Practice Address - Street 1:2641 S C ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4502
Practice Address - Country:US
Practice Address - Phone:805-487-7840
Practice Address - Fax:805-487-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000042314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05597IMedicaid
CAZZT05597IMedicaid