Healthy Life Congregate Care
NPI #1902268758 in Simi Valley, California
Provider Information
- NPI Number
- 1902268758
- Entity Type
- Organization
- Organization Name
- Healthy Life Congregate Care
- Primary Specialty
- Nursing Facility/Intermediate Care Facility
- Enumeration Date
- Mar 22, 2016
- Last Updated
- Mar 22, 2016
Practice Location
- Address
- 3011 PEORIA AVE
- City
- Simi Valley
- State
- California
- ZIP Code
- 93063-1654
- Phone
- (805) 955-0057
Authorized Official
- Name
- DR. EDMOND V DERDERYAN, MD
- Title
- CEO
- Phone
- (805) 955-0057
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nursing Facility/Intermediate Care Facility |
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