Provider Demographics
NPI:1528568169
Name:SH ESCALATE ENTERPRISE, INC.
Entity Type:Organization
Organization Name:SH ESCALATE ENTERPRISE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADM/DPCS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:213-446-3046
Mailing Address - Street 1:2722 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-3030
Mailing Address - Country:US
Mailing Address - Phone:323-643-4880
Mailing Address - Fax:323-643-4838
Practice Address - Street 1:2722 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-3030
Practice Address - Country:US
Practice Address - Phone:323-643-4880
Practice Address - Fax:323-643-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility