Provider Demographics
NPI:1598348625
Name:LEAVE IT TO MANNY
Entity Type:Organization
Organization Name:LEAVE IT TO MANNY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILAT
Authorized Official - Middle Name:
Authorized Official - Last Name:NAHUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-309-0405
Mailing Address - Street 1:1621 S SHERBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4414
Mailing Address - Country:US
Mailing Address - Phone:310-309-0405
Mailing Address - Fax:
Practice Address - Street 1:2602 S HOLT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-2130
Practice Address - Country:US
Practice Address - Phone:424-302-0028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:3919568
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-05
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility