# WHITE OAK CONGREGATE LIVING FACILITY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841662038
- **Authorized official:** MIA VITTE (ADMINISTRATOR)
- **Authorized official phone:** (310) 272-6666

## Contact information

- **Practice address:** 9301 WHITE OAK AVE, NORTHRIDGE, CA 91325-2336
- **Practice address phone:** (818) 885-1135
- **Practice address fax:** (818) 885-1173
- **Mailing address:** 11847 BALBOA BLVD, GRANADA HILLS, CA 91344-2754
- **Mailing address phone:** (310) 272-6666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | — | — |
| 311Z00000X | Custodial Care Facility | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 320700000X | Physical Disabilities Residential Treatment Facility | 550003205 | CA | — |

## Other

- **Enumeration date:** 10/27/2015
- **Last updated:** 12/12/2017