Broadwater Rinaldi Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

920000057 Issued in CA

Legal business name

BROADWATER RINALDI CARE CENTER, LLC

Doing business as

Rinaldi Convalescent Hospital

Practice address

16553 Rinaldi St
Granada Hills, CA 91344-3762

Phone

(818) 360-1003

Fax

(818) 363-8913

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Douglas Easton

Title

Manager

Phone

(818) 368-1862

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rinaldi Convalescent Hospital Doing business as

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1235272170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16553 RINALDI ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443762",
            "telephone_number": "818-360-1003",
            "fax_number": "818-363-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16553 RINALDI ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443762",
            "telephone_number": "818-360-1003",
            "fax_number": "818-363-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWATER RINALDI CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "EASTON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-368-1862"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "920000057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235272170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rinaldi Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marlon Brooks, MD
• Brougham Ambulance
• Shannon Broussalian, M.S., CCC-SLP

• Skilled Nursing Facility in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.