Healthcare Provider Details

I. General information

NPI: 1578332672
Provider Name (Legal Business Name): MSH SENIOR LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2023
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11556 VALERIO ST
NORTH HOLLYWOOD CA
91605-3931
US

IV. Provider business mailing address

11556 VALERIO ST
NORTH HOLLYWOOD CA
91605-3931
US

V. Phone/Fax

Practice location:
  • Phone: 818-565-9740
  • Fax:
Mailing address:
  • Phone: 818-565-9740
  • 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: MIKAEL BADALYAN
Title or Position: CEO
Credential:
Phone: 818-392-0483