Organization
LAKE BALBOA ELDERLY LIVING CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEVON KHOSTIKYAN (CEO)
(424) 303-8478
Entity
Organization
Contact information
Practice address
17221 CANTLAY ST, VAN NUYS, CA 91406-2539
(424) 303-8478
Mailing address
17221 CANTLAY ST, VAN NUYS, CA 91406-2539
(424) 303-8478
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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