Provider Demographics
NPI:1518367788
Name:OVERLAND TERRACE HEALTHCARE & WELLNESS CENTRE LP
Entity Type:Organization
Organization Name:OVERLAND TERRACE HEALTHCARE & WELLNESS CENTRE LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:RECHNITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-800-1191
Mailing Address - Street 1:3580 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2502
Mailing Address - Country:US
Mailing Address - Phone:323-330-6500
Mailing Address - Fax:866-603-3566
Practice Address - Street 1:3515 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5521
Practice Address - Country:US
Practice Address - Phone:310-839-5201
Practice Address - Fax:310-839-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055504Medicare Oscar/Certification