Provider Demographics
NPI:1588385850
Name:COZY CARE CONGREGATE LIVING HEALTH FACILITY INC.
Entity type:Organization
Organization Name:COZY CARE CONGREGATE LIVING HEALTH FACILITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHRIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHODSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-795-7656
Mailing Address - Street 1:1534 N MOORPARK RD # 401
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5129
Mailing Address - Country:US
Mailing Address - Phone:805-991-7237
Mailing Address - Fax:
Practice Address - Street 1:1810 COLGATE DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5003
Practice Address - Country:US
Practice Address - Phone:805-991-7237
Practice Address - Fax:888-823-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility