Provider Demographics
NPI:1780682021
Name:B-SPRING VALLEY, LLC
Entity Type:Organization
Organization Name:B-SPRING VALLEY, LLC
Other - Org Name:BRIGHTON PLACE SPRING VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
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 1:9009 CAMPO RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1112
Mailing Address - Country:US
Mailing Address - Phone:619-460-2711
Mailing Address - Fax:619-460-0451
Practice Address - Street 1:9009 CAMPO RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1112
Practice Address - Country:US
Practice Address - Phone:619-460-2711
Practice Address - Fax:619-460-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090000095314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05685IMedicaid
CA055685Medicare Oscar/Certification