Provider Demographics
NPI:1174367510
Name:CHATSWORTH ASSISTED LIVING
Entity type:Organization
Organization Name:CHATSWORTH ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIY
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-731-2646
Mailing Address - Street 1:20210 TUBA ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3448
Mailing Address - Country:US
Mailing Address - Phone:818-731-2646
Mailing Address - Fax:
Practice Address - Street 1:20210 TUBA ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-3448
Practice Address - Country:US
Practice Address - Phone:818-731-2646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility