Provider Demographics
NPI:1285427062
Name:VALLEY GLEN SENIOR LIVING, INC.
Entity type:Organization
Organization Name:VALLEY GLEN SENIOR LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARGIS
Authorized Official - Middle Name:
Authorized Official - Last Name:AYVAZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-731-6635
Mailing Address - Street 1:7012 LONGRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-4641
Mailing Address - Country:US
Mailing Address - Phone:818-731-6635
Mailing Address - Fax:
Practice Address - Street 1:7054 VANSCOY AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-5357
Practice Address - Country:US
Practice Address - Phone:818-731-6635
Practice Address - Fax:818-960-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility