Healthcare Provider Details

I. General information

NPI: 1841103009
Provider Name (Legal Business Name): CHALAYAH SANCTUARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5781 KIBLURN HIGH RD
PALMDALE CA
93552-5474
US

IV. Provider business mailing address

5781 KIBLURN HIGH RD
PALMDALE CA
93552-5474
US

V. Phone/Fax

Practice location:
  • Phone: 661-600-8621
  • Fax:
Mailing address:
  • Phone: 661-600-8621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ABIODUN OMOLE
Title or Position: CEO
Credential:
Phone: 661-600-8621