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General NPI Number Information
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NPI Number | 1316573793
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Entity Type | Organization
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Legal Business Name | AAA ASSISTED LIVING ELDER CARE LLC
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 17220 BALLINGER ST
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City | NORTHRIDGE
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State | CA
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Zip | 91325-1930
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Country | US
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Telephone | 818-749-8711
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Fax |
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Provider Business Mailing Address
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Address Line | 17220 BALLINGER ST
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City | NORTHRIDGE
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State | CA
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Zip | 91325-1930
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Country | US
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Telephone | 818-749-8711
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARIA GLORIA LUCHERO
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Credential | B.S. DEGREE
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Telephone | 818-749-8711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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