SHERMAN OAKS CONGREGATE LIVING CENTER, INC (NPI# 1609236561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609236561 |
| Entity Type | Organization |
| Organization Name | SHERMAN OAKS CONGREGATE LIVING CENTER, INC |
| Practice Address |
4637 Nagle Ave Sherman Oaks CA 91423-3227 |
| Practice Telephone | 8188788528 |
| Practice Fax Number | 8184501485 |
| Mailing Telephone | 8188788528 |
| Mailing Fax Number | 8184501485 |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2019-02-12 |
| Authorized Official Name | ANNA SAFRAZBEKIAN (CEO) |
| Authorized Official Telephone | 8185714338 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities |
| Street Address |
4637 NAGLE AVE |
| City | SHERMAN OAKS |
| State | CA |
| Zip Code | 91423-3227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790349652 | Emily Luu | Physician Assistant | 4312 Woodman Ave Ste 102, Sherman Oaks, CA 91423 | 2019-04-25 |
| 1821568478 | Allen Tae Chung | Pharmacy | 13331 Moorpark St Apt 333, Sherman Oaks, CA 91423 | 2018-11-27 |
| 1790277267 | Sheridan Kesselman | Counselor | 14272 Valley Vista Blvd., Sherman Oaks, CA 91423 | 2018-05-31 |
| 1033617048 | San Fernando Valley Treatment Ctr.-anxiety Disorders | Social Worker | 13701 Riverside Dr. #508, Sherman Oaks, CA 91423 | 2018-01-24 |
| 1417468737 | Ashford Dental Sherman Oaks | Dentist | 13327 Moorpark St, Sherman Oaks, CA 91423 | 2017-10-13 |
| 1558883470 | Amedi Home Health Care Inc | Home Health | 14242 Ventura Blvd Suite 207, Sherman Oaks, CA 91423 | 2017-07-12 |
| 1902341183 | Oaks Community Pharmacy Inc | Pharmacy | 13322 Riveside Dr, Sherman Oaks, CA 91423 | 2016-12-27 |
| 1558760926 | Baharak Ghaffarzadegan | Dentist | 4346 Matilija Ave #107, Sherman Oaks, CA 91423 | 2014-08-21 |
| 1972947760 | Gwen S. Barry | Marriage & Family Therapist | 13400 Riverside Drive Suite 318, Sherman Oaks, CA 91423 | 2013-04-23 |
| 1043552250 | Community Care Consultants | Social Worker | 14401 Hartsook #315, Sherman Oaks, CA 91423 | 2013-03-26 |
| Find all providers in zip 91423 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881217974 | At Awe LLC | Residential Treatment Facility, Physical Disabilities | 10876 Morning Ridge Dr, Moreno Valley, CA 92557-4202 | 2020-05-22 |
| 1558980896 | Viewcrest Congregate Living | Residential Treatment Facility, Physical Disabilities | 7831 Melita Ave, North Hollywood, CA 91605-1820 | 2020-04-15 |
| 1962046524 | Randy Sarnillo Morelos | Residential Treatment Facility, Physical Disabilities | 9152 Chianti Circle, Stockton, CA 95212 | 2019-11-06 |
| 1518515618 | Dashonia Shaw | Residential Treatment Facility, Physical Disabilities | 3053 N Delno Ave, Fresno, CA 93705-4015 | 2019-08-31 |
| 1114572385 | Twet, LLC | Residential Treatment Facility, Physical Disabilities | 1682 Daybreak Pl, Escondido, CA 92027-1023 | 2019-08-05 |
| 1144873308 | Resurgence California, LLC | Residential Treatment Facility, Physical Disabilities | 3129 Pierce Ave, Costa Mesa, CA 92626-2827 | 2019-07-17 |
| 1891352019 | Mountain View Congregate Living, Inc. | Residential Treatment Facility, Physical Disabilities | 9001 Riderwood Dr, Sunland, CA 91040-2628 | 2019-05-22 |
| 1174014153 | Fresno Congregate Living Inc | Residential Treatment Facility, Physical Disabilities | 3110 E Sierra Ave, Fresno, CA 93710-5917 | 2018-05-24 |
| 1871090803 | Prestige Care Center | Residential Treatment Facility, Physical Disabilities | 474 Sunday Dr, Turlock, CA 95382-9625 | 2018-04-06 |
| 1699281584 | Derani Congregate Living, Inc. | Residential Treatment Facility, Physical Disabilities | 7344 Etiwanda Ave, Reseda, CA 91335-3103 | 2017-12-14 |
| Find all providers with the same taxonomy | ||||
| City | SHERMAN OAKS |
| Zip Code | 91423 |
Please comment or provide details below to improve the information on SHERMAN OAKS CONGREGATE LIVING CENTER, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.