Organization
LAUREL CANYON RETIREMENT COMMUNITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TILLMAN PINK JR. (PRESIDENT)
(818) 769-6629
Entity
Organization
Contact information
Practice address
5527 LAUREL CANYON BLVD, VALLEY VILLAGE, CA 91607-2116
(818) 769-6626
(818) 753-5018
Mailing address
5527 LAUREL CANYON BLVD, VALLEY VILLAGE, CA 91607-2116
(818) 769-6626
(818) 753-5018
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RCF00032F
—
CA
Enumeration date
12/07/2007
Last updated
12/07/2007
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