Provider Demographics
NPI:1619965209
Name:C & H HEALTH CARE
Entity Type:Organization
Organization Name:C & H HEALTH CARE
Other - Org Name:CENTINELA PARK CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:FLORO
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-965-0600
Mailing Address - Street 1:515 CENTINELA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-3215
Mailing Address - Country:US
Mailing Address - Phone:310-674-4500
Mailing Address - Fax:310-674-9393
Practice Address - Street 1:515 CENTINELA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-3215
Practice Address - Country:US
Practice Address - Phone:310-674-4500
Practice Address - Fax:310-674-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-08
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05608GMedicaid
CA055608Medicare ID - Type Unspecified