Provider Demographics
NPI:1871166645
Name:MADISON RETIREMENT FACILITY, INC
Entity type:Organization
Organization Name:MADISON RETIREMENT FACILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MENLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-816-8880
Mailing Address - Street 1:23450 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4701
Mailing Address - Country:US
Mailing Address - Phone:310-539-6826
Mailing Address - Fax:310-539-6829
Practice Address - Street 1:23450 MADISON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4701
Practice Address - Country:US
Practice Address - Phone:310-539-6826
Practice Address - Fax:310-539-6829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility