Organization
LEISURE VALE RETIREMENT HOTEL
Active
Other names
B. V. General, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. POLITA BARNES (ADMINISTRATOR)
(818) 244-2323
Entity
Organization
Contact information
Practice address
413 E CYPRESS ST, GLENDALE, CA 91205-3334
(818) 244-2323
(818) 244-3147
Mailing address
413 E CYPRESS ST, GLENDALE, CA 91205-3334
(818) 244-2323
(818) 244-3147
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RCF00017F
MEDI-CAL
CA
Enumeration date
07/19/2007
Last updated
07/19/2007
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