Active NPI
Crenshaw Nursing Home LLC
- Skilled Nursing Facility
- Los Angeles, CA
National Provider Identifier
1386728939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 910000143
- Legal business name
- CRENSHAW NURSING HOME LLC
- Practice address
- 1900 Longwood Ave
Los Angeles, CA 90016-1408 - Phone
- (323) 933-1560
- Fax
- (323) 936-9030
- NPI assigned
- Oct 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kerri Sandoval
- Title
- Administrative Asst
- Phone
- (213) 389-6900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 910000143 | CA | Primary |
Addresses
Primary practice location
1900 Longwood Ave
Los Angeles, CA 90016-1408
Mailing address
4032 Wilshire Blvd FL 6
Los Angeles, CA 90010-3425
Phone (213) 389-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT05525F | Medicaid | CA |
Other names 1
- Crenshaw Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120731000222 | CA | Part A Provider - Skilled Nursing Facility | 8123284528 | Practice locations: Los Angeles, CA |
Skilled nursing facility certification: CCN 055525
- Legal name
- CRENSHAW ENTERPRISES, INC.
- Doing business as
- CRENSHAW NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 6, 1967
- Last certification
- Mar 21, 2025
- Beds
- 55
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Longwood Managment Corporation
- Organization structure
- Corporation
- Incorporated
- Jul 8, 1966 in CA
- Enrollment address
- 1900 S Longwood Ave
Los Angeles, CA 90016-1408 - Nursing home name
- CRENSHAW NURSING HOME
- Affiliated entity
- LONGWOOD MANAGEMENT CORPORATION
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Crenshaw Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 6, 1967
- Medicare certification status
- Active
- Certified beds
- 55
- Chain
- Longwood Management Corporation
- Penalties (3 years)
- 4
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey Huang | W-2 Managing Employee | Aug 30, 2022 | |
| Friedman Living Trust | 5% Or Greater Indirect Ownership Interest | May 2, 1984 | 100% |
| Longwood Management LLC | Operational/Managerial Control | Feb 23, 2012 | |
| Ira David Friedman | Corporate Officer | Jul 8, 1966 | |
| Corporate Director | Jul 8, 1966 | ||
| Zaid Pervaiz | Other | Jan 7, 2022 |
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Whittier, CA
- NPI 1679657993
Longwood Management LLC
-
- Skilled Nursing Facility
- Los Angeles, CA
- NPI 1427131556
Friedman Living Trust
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1782172800000",
"number": "1386728939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4032 WILSHIRE BLVD FL 6",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103425",
"telephone_number": "213-389-6900",
"fax_number": "323-936-9030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 LONGWOOD AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900161408",
"telephone_number": "323-933-1560",
"fax_number": "323-936-9030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CRENSHAW NURSING HOME LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-24",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A",
"authorized_official_last_name": "SANDOVAL",
"authorized_official_first_name": "KERRI",
"authorized_official_title_or_position": "ADMINISTRATIVE ASST",
"authorized_official_telephone_number": "213-389-6900"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "910000143",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT05525F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Crenshaw Nursing Home",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Crenshaw Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.