Healthcare Provider Details

I. General information

NPI: 1164335048
Provider Name (Legal Business Name): ANGEL OAK RESIDENTIAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7356 WHITE OAK AVE
VAN NUYS CA
91406-2347
US

IV. Provider business mailing address

7356 WHITE OAK AVE
VAN NUYS CA
91406-2347
US

V. Phone/Fax

Practice location:
  • Phone: 747-369-9023
  • Fax:
Mailing address:
  • Phone: 747-369-9023
  • 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: JEEVAN ZAMBRE
Title or Position: CEO
Credential:
Phone: 747-369-9023