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General NPI Number Information
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NPI Number | 1942718853
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Entity Type | Organization
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Legal Business Name | CATHEDRAL CONGREGATE LIVING, INC
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 68315 RIVIERA RD
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-4843
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Country | US
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Telephone | 323-823-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 68315 RIVIERA RD
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-4843
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Country | US
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Telephone | 323-823-8828
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ARUTYUN BALYAN
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Credential |
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Telephone | 323-823-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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