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NPI 1962313726

NPI 1962313726 : AMANAH SENIOR LIVING, LLC : ALTADENA, CA

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General NPI Number Information
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    NPI Number           |    1962313726
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMANAH SENIOR LIVING, LLC 
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Dates
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    Enumeration Date     |    09/12/2026
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    Last Update Date     |    09/12/2026
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Provider Practice Location Address
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    Address Line         |    400 E CALAVERAS ST 
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    City                 |    ALTADENA
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    State                |    CA
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    Zip                  |    91001-2218
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    Country              |    US
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    Telephone            |    626-499-4212
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    Fax                  |    626-210-2574
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Provider Business Mailing Address
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    Address Line         |    400 E CALAVERAS ST 
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    City                 |    ALTADENA
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    State                |    CA
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    Zip                  |    91001-2218
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    Country              |    US
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    Telephone            |    626-499-4212
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    Fax                  |    626-210-2574
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     IMRAN  SYED 
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    Credential           |    
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    Telephone            |    626-499-4212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    311ZA0620X
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    Taxonomy Name        |    Adult Care Home Facility
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    385H00000X
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    Taxonomy Name        |    Respite Care
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    License Number       |    
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    License Number State |    
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