Provider Demographics
NPI:1518157155
Name:ISOCARE CONVALESCENT HOSPITAL OF MONTE VISTA INC.
Entity Type:Organization
Organization Name:ISOCARE CONVALESCENT HOSPITAL OF MONTE VISTA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-644-5151
Mailing Address - Street 1:13527 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5807
Mailing Address - Country:US
Mailing Address - Phone:310-644-5151
Mailing Address - Fax:310-644-5590
Practice Address - Street 1:13527 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5807
Practice Address - Country:US
Practice Address - Phone:310-644-5151
Practice Address - Fax:310-644-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility