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General NPI Number Information
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NPI Number | 1467865402
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Entity Type | Organization
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Legal Business Name | GENERATION SENIOR CARE INC.
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Dates
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Enumeration Date | 06/07/2014
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Last Update Date | 06/07/2014
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Provider Practice Location Address
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Address Line | 9611 CORBIN AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2121
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Country | US
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Telephone | 818-388-4728
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Fax | 818-349-1995
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Provider Business Mailing Address
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Address Line | 17241 RAYMER ST
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City | SHERWOOD FOREST
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State | CA
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Zip | 91325-3445
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Country | US
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Telephone | 818-388-4728
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Fax | 818-349-1995
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PAUL ANDREI KENEZ
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Credential |
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Telephone | 818-388-4728
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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 | 197608073
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License Number State | CA
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