Organization Active NPI

Longwood Enterprises LLC

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1235213810
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LONGWOOD ENTERPRISES LLC
Practice address
4853 W Washington Blvd
Los Angeles, CA 90016-1501
Phone
(323) 935-1157
Fax
(323) 935-7204
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ira David Friedman
Title
Manager
Phone
(213) 389-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4853 W Washington Blvd
Los Angeles, CA 90016-1501

Mailing address

4032 Wilshire Blvd FL6
Los Angeles, CA 90010-3425
Phone (213) 389-6900

Other identifiers 1

IdentifierTypeStateIssuer
1235213810MedicaidCA

Other names 1

  • Longwood Manor Convalescent Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120427000561 CA Part A Provider - Skilled Nursing Facility 9133381692 Practice locations: Los Angeles, CA

Skilled nursing facility certification: CCN 055753

Legal name
LONGWOOD ENTERPRISES LLC
Doing business as
LONGWOOD MANOR CONVALESCENT HOSPITAL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 11, 1967
Last certification
May 9, 2025
Beds
198
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
May 19, 1964 in CA
Enrollment address
4853 W Washington Blvd
Los Angeles, CA 90016-1501
Nursing home name
LONGWOOD MANOR CONV.HOSPITAL
Affiliated entity
LONGWOOD MANAGEMENT CORPORATION

Care Compare: Nursing home

Medicare Care Compare
Listed as
Longwood Manor Conv.HospitalCCN 055753
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 11, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
198187.3 residents per day on average
Chain
Longwood Management Corporation38 facilities in the chain
Penalties (3 years)
4Fines totaling $24,465

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0689107Longwood Manor Convalescent Hospital4853 W Washington, Los Angeles, CA 90016Certificate of waiverNov 22, 2027

National Provider Directory

National Provider Directory

Locations

4853 W Washington Blvd
Los Angeles, CA 90016
Phone (323) 935-1157

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rachel Klavan Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 20%
Corporate DirectorDirector Jun 30, 2023 20%
Ira David Friedman Group a Business Assets Trust Organization, Los Angeles, CA 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Aaron Friedman Group a Business Assets Trust Organization, Los Angeles, CA 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Libby Friedman Lehmann Group a Business Assets Trust Organization, Los Angeles, CA 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Longwood Management LLC Organization, Los Angeles, CA LLC, For-profit Other Jul 1, 1995
Ruchel Friedman Klavan Group a Business Assets Trust Organization, Los Angeles, CA 5% Or Greater Direct Ownership Interest Jun 30, 2023 20%
Ira David Friedman Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2023 20%
Corporate OfficerManager Jun 30, 2023 20%
Corporate DirectorDirector Jun 30, 2023 20%
Zaid Pervaiz Individual Other Jan 7, 2022
Vandana Dhawan-Desai Individual W-2 Managing EmployeeAdministrator Dec 23, 2022

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1235213810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 WILSHIRE BLVD FL6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103425",
            "telephone_number": "213-389-6900",
            "fax_number": "323-935-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4853 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900161501",
            "telephone_number": "323-935-1157",
            "fax_number": "323-935-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGWOOD ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "213-389-6900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235213810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Longwood Manor Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Longwood Manor Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.