MEDICARE: HIGHLANDS MANOR 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1154272961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLANDS MANOR INC

Provider Business Mailing Address
First Line	:	18232 CHARLTON LN
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-3616
Country	:	US
Telephone Number	:	818-625-0419
Fax Number	:	818-483-9151

Provider Business Practice Location Address
First Line	:	9811 BELMAR AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-1609
Country	:	US
Telephone Number	:	747-206-5436
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RUSLAN LEVIN
Credential	:
Telephone Number	:	818-625-0419

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “HIGHLANDS MANOR INC ” Practice Location

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