Lake Balboa Congregate Living
NPI #1508246034 in Lake Balboa, California
Provider Information
- NPI Number
- 1508246034
- Entity Type
- Organization
- Organization Name
- Lake Balboa Congregate Living
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 29, 2015
- Last Updated
- May 29, 2015
Practice Location
- Address
- 17527 COVELLO ST
- City
- Lake Balboa
- State
- California
- ZIP Code
- 91406-2320
- Phone
- (818) 773-0700
Authorized Official
- Name
- JOHN GEVORGYAN
- Title
- CEO
- Phone
- (818) 773-0700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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