Provider Demographics
NPI:1700151156
Name:ALHAMBRA SERVICES CORPORATION
Entity Type:Organization
Organization Name:ALHAMBRA SERVICES CORPORATION
Other - Org Name:BETHANY TOWERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUSHFORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-467-3121
Mailing Address - Street 1:1745 N GRAMERCY PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-5863
Mailing Address - Country:US
Mailing Address - Phone:323-467-3121
Mailing Address - Fax:323-469-0627
Practice Address - Street 1:1745 N GRAMERCY PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-5863
Practice Address - Country:US
Practice Address - Phone:323-467-3121
Practice Address - Fax:323-469-0627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191800073310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility