# CONGREGATE LIVING HEALTH FACILITY, INC.

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

## Provider details

- **NPI number:** 1851720486
- **Authorized official:** MR. LEANDER JACKSON JR. (PRESIDENT / OWNER)
- **Authorized official phone:** (805) 253-6708

## Contact information

- **Practice address:** 5440 TUJUNGA AVE, NORTH HOLLYWOOD, CA 91601-4967
- **Practice address phone:** (805) 253-6708
- **Practice address fax:** (888) 640-4414
- **Mailing address:** 5440 TUJUNGA AVE, NORTH HOLLYWOOD, CA 91601-4967
- **Mailing address phone:** (805) 253-6708
- **Mailing address fax:** (888) 640-4414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2013
- **Last updated:** 11/04/2013