The Cottages of Lake Balboa, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE COTTAGES OF LAKE BALBOA, INC.

Practice address

6724 Gaviota Ave
Lake Balboa, CA 91406-5944

Phone

(818) 378-7422

Fax

(855) 225-2622

NPI assigned

Apr 4, 2024

Last updated

Apr 4, 2024By 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

Justin Levi

Title

President

Phone

(818) 378-7422

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1841042413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 WILSHIRE BLVD # 2070",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485126",
            "telephone_number": "818-378-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6724 GAVIOTA AVE",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914065944",
            "telephone_number": "818-378-7422",
            "fax_number": "855-225-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COTTAGES OF LAKE BALBOA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "LEVI",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-378-7422"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Lake Balboa, CA
• Providers in Lake Balboa, 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 4, 2024; 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.