Provider Demographics
NPI:1790222388
Name:NURSING & REHAB AT CAMERON LLC
Entity Type:Organization
Organization Name:NURSING & REHAB AT CAMERON LLC
Other - Org Name:REDWOOD OF CAMERON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-405-3377
Mailing Address - Street 1:4601 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3880
Mailing Address - Country:US
Mailing Address - Phone:323-405-3377
Mailing Address - Fax:323-900-0285
Practice Address - Street 1:801 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-2003
Practice Address - Country:US
Practice Address - Phone:816-632-7254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RED WOOD HEALTHCARE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-20
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility