Active NPI
Paradise Congregate Living Inc
- Nursing Facility/Intermediate Care Facility
- Van Nuys, CA
National Provider Identifier
1720406762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 550003206
- Legal business name
- PARADISE CONGREGATE LIVING INC
- Practice address
- 14822 Cohasset St
Van Nuys, CA 91405-1803 - Phone
- (855) 747-0777
- NPI assigned
- Apr 6, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Liliana Cohen, MD
- Title
- Ceo
- Phone
- (855) 747-0777
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 550003206 | CA | Primary |
Addresses
Primary practice location
14822 Cohasset St
Van Nuys, CA 91405-1803
Mailing address
14822 Cohasset St
Van Nuys, CA 91405-1803
Phone (855) 747-0777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5404141 | Medicaid | CA | |
| 550003206 | Other | CA | CDPH |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1720406762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14822 COHASSET ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051803",
"telephone_number": "855-747-0777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14822 COHASSET ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051803",
"telephone_number": "855-747-0777"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARADISE CONGREGATE LIVING INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-06",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "COHEN",
"authorized_official_first_name": "LILIANA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "855-747-0777",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "CA",
"license": "550003206",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5404141",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPH",
"identifier": "550003206",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.