Glen Park East

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

191221691 Issued in CA

Legal business name

GLEN PARK EAST

Practice address

1250 Boynton St
Glendale, CA 91205-3451

Phone

(818) 246-9000

Fax

(818) 246-1577

NPI assigned

Aug 7, 2008

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) 242-9000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1205082476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MARIPOSA ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053254",
            "telephone_number": "818-242-9000",
            "fax_number": "818-242-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BOYNTON ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053451",
            "telephone_number": "818-246-9000",
            "fax_number": "818-246-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN PARK EAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "PINK",
        "authorized_official_first_name": "TILLMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-242-9000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "191221691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RCF00031F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gladhearts Senior Services (Visiting Angels Living Assistance Services)
• Elena Vladimirovna Glassmaker, FNP
• Camber Spring Gleim, NBC-HWC
• Glen Dental Studio
• Glen Park at Glendale - Mariposa St
• Glen-Park West Retirement Community, Inc
• Glen-White Urological Medical Group Inc
• Glen-White Urological Medical Group Inc
• Glenburb Home Health Inc
• Glenburb Hospice Inc

• Assisted Living Facility in Glendale, CA
• Providers in Glendale, 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 Aug 7, 2008; 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.