Healthcare Provider Details

I. General information

NPI: 1477930980
Provider Name (Legal Business Name): WEST VALLEY CONGREGATE HEALTH LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8035 OAKDALE AVE
WINNETKA CA
91306-1932
US

IV. Provider business mailing address

8035 OAKDALE AVE
WINNETKA CA
91306-1932
US

V. Phone/Fax

Practice location:
  • Phone: 818-349-1688
  • Fax: 818-349-1678
Mailing address:
  • Phone: 818-349-1688
  • Fax: 818-349-1678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NARINE KYURUMYAN
Title or Position: CEO
Credential:
Phone: 818-349-1688