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General NPI Number Information
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NPI Number | 1417627720
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Entity Type | Organization
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Legal Business Name | AFFORDABLE LIVING FOR THE AGING
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 937 N FAIRFAX ATTN: OFFICE, 5TH FLOOR
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046
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Country | US
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Telephone | 323-606-7657
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Fax |
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Provider Business Mailing Address
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Address Line | 937 N. FAIRFAX AV ATTN: OFFICE, 5TH FL.
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046
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Country | US
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Telephone | 231-400-2371
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | ANTONIO MANNING
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Credential |
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Telephone | 213-400-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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