Basic Information
| Provider Information | |||||||||
| NPI: | 1710432240 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HP NURSING & REHAB LLC | ||||||||
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| OtherOrganizationName: | HIGHLAND PINES NURSING HOME | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 WILSHIRE BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900103883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235054345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 N 4TH ST | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756014739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9037537661 | ||||||||
| FaxNumber: | 9037531056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2016 | ||||||||
| LastUpdateDate: | 11/06/2018 | ||||||||
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| AuthorizedOfficialLastName: | GURWITZ | ||||||||
| AuthorizedOfficialFirstName: | SOLOMON | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3235054345 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | TX | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.