Evelyn'S Manor LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EVELYN'S MANOR LLC

Practice address

1126 E 82ND St
Los Angeles, CA 90001-3310

Phone

(323) 484-0039

NPI assigned

May 21, 2025

Organization subpart

No

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

Authorized official

Name

Kaylon Hallman

Title

Administrator

Phone

(310) 739-9303

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1962294322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 E 82ND ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013310",
            "telephone_number": "323-484-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 E 82ND ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013310",
            "telephone_number": "323-484-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN'S MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "HALLMAN",
        "authorized_official_first_name": "KAYLON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-739-9303"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Los Angeles, CA
• Providers in Los Angeles, 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 May 21, 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.