Healthcare Provider Details

I. General information

NPI: 1346160124
Provider Name (Legal Business Name): GRANADA GOLDEN YEARS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17201 LAHEY ST
GRANADA HILLS CA
91344-4142
US

IV. Provider business mailing address

17201 LAHEY ST
GRANADA HILLS CA
91344-4142
US

V. Phone/Fax

Practice location:
  • Phone: 747-351-4203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: RUBEN SARGSYAN
Title or Position: CEO
Credential:
Phone: 747-351-4203