Healthcare Provider Details

I. General information

NPI: 1154244168
Provider Name (Legal Business Name): LEGACY TERRACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9823 RATHBURN AVE
NORTHRIDGE CA
91325-1741
US

IV. Provider business mailing address

9823 RATHBURN AVE
NORTHRIDGE CA
91325-1741
US

V. Phone/Fax

Practice location:
  • Phone: 818-626-8954
  • Fax:
Mailing address:
  • Phone: 818-626-8954
  • 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: PALIE KARAMANOUGIAN
Title or Position: OWNER
Credential:
Phone: 818-395-9135