Provider Demographics
NPI:1952383168
Name:GERI-CARE II, INC.
Entity Type:Organization
Organization Name:GERI-CARE II, INC.
Other - Org Name:VERMONT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:TUAZON
Authorized Official - Last Name:VILLALUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-328-0812
Mailing Address - Street 1:22035 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2120
Mailing Address - Country:US
Mailing Address - Phone:310-328-0812
Mailing Address - Fax:310-782-3890
Practice Address - Street 1:22035 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2120
Practice Address - Country:US
Practice Address - Phone:310-328-0812
Practice Address - Fax:310-782-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC06433JMedicaid
CALTC06433JMedicaid