MEDICARE: SANTA CLARITA CONGREGATE LIVING INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1083223481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA CLARITA CONGREGATE LIVING INC.

Provider Business Mailing Address
First Line	:	29830 WISTARIA VALLEY RD
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91387-1954
Country	:	US
Telephone Number	:	818-523-0729
Fax Number	:	661-857-8293

Provider Business Practice Location Address
First Line	:	29830 WISTARIA VALLEY RD
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91387-1954
Country	:	US
Telephone Number	:	818-523-0729
Fax Number	:	661-857-8293

Authorized Official
Title or Position	:	OWNER
Name	:	MR. AKSEL ABRAMYAN
Credential	:	R.N., B.S.N.
Telephone Number	:	818-523-0729

Provider Enumeration Date	:	07/31/2020
Last Update Date	:	09/30/2021

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