Healthcare Provider Details

I. General information

NPI: 1710814314
Provider Name (Legal Business Name): CJ'S ELDER HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18718 SATICOY ST
RESEDA CA
91335-2749
US

IV. Provider business mailing address

18718 SATICOY ST
RESEDA CA
91335-2749
US

V. Phone/Fax

Practice location:
  • Phone: 818-849-9046
  • Fax:
Mailing address:
  • Phone: 818-849-9046
  • 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: MADONNA OLILA
Title or Position: CEO
Credential:
Phone: 818-294-9129