Provider Demographics
NPI:1831363548
Name:EPISCOPAL COMMUNITIES & SERVICES FOR SENIORS
Entity type:Organization
Organization Name:EPISCOPAL COMMUNITIES & SERVICES FOR SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-403-1482
Mailing Address - Street 1:1111 S ARROYO PARKWAY
Mailing Address - Street 2:STE 230
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3259
Mailing Address - Country:US
Mailing Address - Phone:626-403-5880
Mailing Address - Fax:626-403-5881
Practice Address - Street 1:5801 WEST CRESTRIDGE RD
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS
Practice Address - State:CA
Practice Address - Zip Code:90275
Practice Address - Country:US
Practice Address - Phone:310-541-2410
Practice Address - Fax:626-281-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA910000128314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility