Palmdale Congregate Living, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PALMDALE CONGREGATE LIVING, INC.

Practice address

38702 12TH St E
Palmdale, CA 93550-3990

Phone

(818) 731-4664

NPI assigned

Feb 7, 2015

Last updated

Feb 7, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mourad Mike Tokatlyan

Title

Ceo

Phone

(818) 753-4664

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423267200000",
    "number": "1134510530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38702 12TH ST E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935503990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38702 12TH ST E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935503990",
            "telephone_number": "818-731-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMDALE CONGREGATE LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-07",
        "last_updated": "2015-02-07",
        "status": "A",
        "authorized_official_last_name": "TOKATLYAN",
        "authorized_official_first_name": "MOURAD",
        "authorized_official_middle_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-753-4664"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.