Healthcare Provider Details

I. General information

NPI: 1073690384
Provider Name (Legal Business Name): ASSISTED LIVING FOUNDATION OF AMERICA, VAN NUYS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 SEPULVEDA BLVD
VAN NUYS CA
91405
US

IV. Provider business mailing address

7447 SEPULVEDA BLVD
VAN NUYS CA
91405
US

V. Phone/Fax

Practice location:
  • Phone: 818-787-3400
  • Fax: 818-902-5365
Mailing address:
  • Phone: 818-787-3400
  • Fax: 818-902-5365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. LAWRENCE FIEGEN
Title or Position: VICE PRESIDENT
Credential:
Phone: 310-385-1090