Lilos Tender Senior Care Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LILOS TENDER SENIOR CARE INC

Practice address

4149 Rolando Blvd
San Diego, CA 92115-6813

Phone

(818) 284-2502

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Anna Petrosyan

Title

Ceo

Phone

(818) 284-2502

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1548016561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13153 CONSTABLE AVE",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913441106",
            "telephone_number": "818-284-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4149 ROLANDO BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156813",
            "telephone_number": "818-284-2502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4146 Rolando Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921156812",
            "country_code": "US",
            "telephone_number": "818-284-2502",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9414 Grossmont Blvd",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919414148",
            "country_code": "US",
            "telephone_number": "818-445-1590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LILOS TENDER SENIOR CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "PETROSYAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-284-2502"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Michael Lillie, M.D.
• Laura Lilly Faherty, RBT
• Abigail Lilly
• Elizabeth Anne Lilly, OTR/L
• Mary L Lilly, PHD RN MS MSN
• Joyce Beth Lilya, LCSW
• Makenna Brianne Lilya, AMFT
• Albert Y Lim, D.O.
• Antony Y Lim, L.AC.
• Ben K Lim, PH.D.

• Assisted Living Facility in San Diego, CA
• Providers in San Diego, 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 Apr 15, 2025; 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.