| NPI | 1902655830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR CHERTOK Licensee Representative 818-422-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-23 |