COUNTRY VILLA SOUTH BAY, LLC

Skilled Nursing Facility

OIG CLEARNPI VERIFIED

Location

VAN NUYS, CA

Licensed since

2005

Rate

—

Federal identifiers

NPI registry number1104810159

Agency details

Medicare activity

StatusNo Medicare utilization on file — neutral.

Authorized official

NameSTEPHEN REISSMAN

TitleTRUSTEE OF MANAGING MEMBER

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