NPIMap

Organization Active NPI

Northridge Manor

  • Mental Illness Intermediate Care Facility
  • Northridge, CA
National Provider Identifier
1972259190
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
Legal business name
NORTHRIDGE MANOR
Practice address
9501 Vanalden Ave
Northridge, CA 91324-1762
Phone
(818) 203-7779
NPI assigned
Feb 25, 2022
Last updated
Feb 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Arsen Andreasyan
Title
Ceo
Phone
(818) 203-7779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X Primary

Addresses

Primary practice location

9501 Vanalden Ave
Northridge, CA 91324-1762

Mailing address

9501 Vanalden Ave
Northridge, CA 91324-1762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972259190. Details of each certification follow.

  • CCN 55G814 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G814

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NORTHRIDGE MANOR
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 26, 2024
Last certification
Aug 20, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
9501 Vanalden Ave
Northridge, CA 91324

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1972259190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 VANALDEN AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 VANALDEN AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241762",
            "telephone_number": "818-203-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "ANDREASYAN",
        "authorized_official_first_name": "ARSEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-203-7779"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.