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General NPI Number Information
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NPI Number | 1659261337
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Entity Type | Organization
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Legal Business Name | CHATSWORTH CONGREGATE LIVING HEALTH FACILITY LLC
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 9648 QUAKERTOWN AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-5522
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Country | US
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Telephone | 818-510-4633
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Fax | 818-510-4648
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Provider Business Mailing Address
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Address Line | 4271 UPTOWN NEWPORT DR UNIT 1
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3096
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Country | US
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Telephone | 714-657-5777
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Fax | 818-510-4648
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARITA FORTADES
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Credential | MD
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Telephone | 818-510-4633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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