Valley Vista Residential Manor LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

VALLEY VISTA RESIDENTIAL MANOR LLC

Doing business as

Valley Manor Guest Home

Practice address

6130 Vineland Ave
North Hollywood, CA 91606-4914

Phone

(818) 766-8161

Fax

(818) 643-8753

NPI assigned

Jun 7, 2018

Last updated

Mar 26, 2020By 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

Ginger PO

Title

Ceo

Phone

(949) 648-2737

Specialties & licenses 1

Addresses

Other names 1

• VALLEY MANOR GUEST HOME Doing business as

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1275026957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 VINELAND AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064914",
            "telephone_number": "949-648-2737",
            "fax_number": "949-608-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 VINELAND AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064914",
            "telephone_number": "818-766-8161",
            "fax_number": "818-643-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VISTA RESIDENTIAL MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "PO",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-648-2737"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VALLEY MANOR GUEST HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valley View Congregate Living Facility, Inc.
• Valley Village Care Center LLC (Valley Village Care Center)
• Valley Village Pharmacy, Inc. (Valley Village Pharmacy)
• Valley Village Pharmacy, Inc.
• Valley Vista Nursing and Transitional Care LLC
• Valleys Finest Hospice Care, Inc.
• Valleystar, Inc. (Brightstar Healthcare)
• Dorit Gal Vampan, P.T.
• Vana Hospice, Inc.
• Jessica Vancleave

• Assisted Living Facility (Mental Illness) in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Assisted Living Facility (Mental Illness) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.