Laurel Canyon Retirement Community, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAUREL CANYON RETIREMENT COMMUNITY, INC

Practice address

5527 Laurel Canyon Blvd
Valley Village, CA 91607-2116

Phone

(818) 769-6626

Fax

(818) 753-5018

NPI assigned

Dec 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tillman Pink Jr.

Title

President

Phone

(818) 769-6629

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Glen Park at Valley Village2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Glen Park at Valley Village

  • Alzheimer Center (Dementia Center)
  • Valley Village, CA
  • NPI 1942484837
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1093998411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5527 LAUREL CANYON BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072116",
            "telephone_number": "818-769-6626",
            "fax_number": "818-753-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5527 LAUREL CANYON BLVD",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916072116",
            "telephone_number": "818-769-6626",
            "fax_number": "818-753-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL CANYON RETIREMENT COMMUNITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "PINK",
        "authorized_official_first_name": "TILLMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-769-6629",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RCF00032F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Kussin, PH.D.
• Jane Kwon, LMFT
• Carlos Manuel Laack, LMFT
• Andrew Lawrence Lande, LMFT
• Gilian Neiditch Lata, LAC, DIPL OM
• Laurel Grove Medical Center Inc
• Paige Elaine Lauren-Taylor, AMFT
• Allison Lazar, BCBA
• Sharona C Lazar, RD
• Ellen Lazares, L.AC.

• Assisted Living Facility in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.