Provider Demographics
NPI: | 1457747834 |
---|---|
Name: | VALLEY VIEW CONGREGATE LIVING |
Entity type: | Organization |
Organization Name: | VALLEY VIEW CONGREGATE LIVING |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NARINE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ALADJANIAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 323-370-5003 |
Mailing Address - Street 1: | 7800 ATOLL AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTH HOLLYWOOD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 91605-1837 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 323-370-5003 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7800 ATOLL AVE |
Practice Address - Street 2: | |
Practice Address - City: | NORTH HOLLYWOOD |
Practice Address - State: | CA |
Practice Address - Zip Code: | 91605-1837 |
Practice Address - Country: | US |
Practice Address - Phone: | 323-370-5003 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-04-12 |
Last Update Date: | 2015-04-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | ========= | Medicaid |