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General NPI Number Information
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NPI Number | 1770761363
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Entity Type | Organization
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Legal Business Name | E D GARDENS INC.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 23601 CANZONET ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-5845
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Country | US
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Telephone | 818-348-2308
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Fax |
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Provider Business Mailing Address
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Address Line | 3630 TERRACE VIEW DR
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City | ENCINO
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State | CA
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Zip | 91436-4020
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Country | US
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Telephone | 818-784-8624
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Fax | 818-783-2840
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ROHANGIZ SOLAIMANI YADIDI
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Credential |
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Telephone | 818-784-8624
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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 | CA
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