Derani Congregate Living, Inc.

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

DERANI CONGREGATE LIVING, INC.

Practice address

7344 Etiwanda Ave
Reseda, CA 91335-3103

Phone

(626) 733-1062

Fax

(818) 975-5534

NPI assigned

Dec 14, 2017

Organization subpart

No

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

Authorized official

Name

Ani Davidagayan

Title

Ceo

Phone

(626) 733-1062

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1699281584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7344 ETIWANDA AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353103",
            "telephone_number": "626-733-1062",
            "fax_number": "818-975-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7344 ETIWANDA AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353103",
            "telephone_number": "626-733-1062",
            "fax_number": "818-975-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERANI CONGREGATE LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A",
        "authorized_official_last_name": "DAVIDAGAYAN",
        "authorized_official_first_name": "ANI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-733-1062"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Reseda, CA by specialty
• Physical Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.