Healthcare Provider Details

I. General information

NPI: 1548924582
Provider Name (Legal Business Name): AFFORDABLE LIVING FOR THE AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 N FAIRFAX, 5TH FLOOR OFFICE
WEST HOLLYWOOD CA
90046
US

IV. Provider business mailing address

937 N FAIRFAX AVE OFC
WEST HOLLYWOOD CA
90046-7280
US

V. Phone/Fax

Practice location:
  • Phone: 310-600-9198
  • Fax:
Mailing address:
  • Phone: 323-650-7988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: CANDICE SCOTT
Title or Position: CHIEF DEVELOPMENT OFFICER
Credential:
Phone: 310-600-9198