MEDICARE: VALLEY VILLAGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	LTC60395F	CA

General Provider Information

NPI Number	:	1609927136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VILLAGE

Provider Business Mailing Address
First Line	:	20830 SHERMAN WAY
Second Line	:
City	:	WINNETKA
State	:	CA
Zip	:	91306-2707
Country	:	US
Telephone Number	:	818-587-9450
Fax Number	:	818-587-9184

Provider Business Practice Location Address
First Line	:	9258 HAYVENHURST AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-3607
Country	:	US
Telephone Number	:	818-587-9450
Fax Number	:	818-587-9184

Authorized Official
Title or Position	:	ACCOUNT'S RECEIVABLE MANAGER
Name	:	MS. JOANNE TSCHANTRE
Credential	:
Telephone Number	:	818-587-9450

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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Directions to “VALLEY VILLAGE ” Practice Location

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