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General NPI Number Information
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NPI Number | 1427733054
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Entity Type | Organization
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Legal Business Name | SEDONA GUEST HOME
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 21635 HOWARD AVE
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City | TORRANCE
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State | CA
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Zip | 90503-6220
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Country | US
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Telephone | 310-792-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 5325 LA CANADA BLVD
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City | LA CANADA FLINTRIDGE
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State | CA
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Zip | 91011-1724
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Country | US
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Telephone | 818-421-0594
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR / LICENSEE
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Name | MR. ANTONIO ARBOLEDA
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Credential |
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Telephone | 818-421-0594
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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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