B.V. General, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

970000040 Issued in CA

Legal business name

B.V. GENERAL, INC.

Doing business as

Leisure Glen Care Center

Practice address

300 Mission Avenue
Glendale, CA 91205-3316

Phone

(818) 247-4476

Fax

(818) 247-1776

NPI assigned

Jun 28, 2005

Last updated

Apr 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Fernan Pedraja

Title

Financial Controller

Phone

(181) 824-7620

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Leisure Glen Care Center Doing business as

Locations

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1255338810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053316",
            "telephone_number": "181-824-7620",
            "fax_number": "181-824-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MISSION AVENUE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053316",
            "telephone_number": "818-247-4476",
            "fax_number": "818-247-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B.V. GENERAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "PEDRAJA",
        "authorized_official_first_name": "FERNAN",
        "authorized_official_title_or_position": "FINANCIAL CONTROLLER",
        "authorized_official_telephone_number": "181-824-7620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC05845H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NUMBER",
            "identifier": "05D0556903",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leisure Glen Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Glendale, CA
• Providers in Glendale, 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 21, 2016; 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.