Provider Demographics
NPI:1770296758
Name:HALLMARK SENIOR LIVING LLC
Entity type:Organization
Organization Name:HALLMARK SENIOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:MAX
Authorized Official - Last Name:THURM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-512-3884
Mailing Address - Street 1:236 S MANSFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3017
Mailing Address - Country:US
Mailing Address - Phone:516-512-3884
Mailing Address - Fax:
Practice Address - Street 1:2001 AKERS RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-5058
Practice Address - Country:US
Practice Address - Phone:661-834-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA157209304OtherCOMMUNITY CARE LICENSING DIVISION