Organization
VALLEY VISTA RESIDENTIAL MANOR LLC
Active
Other names
VALLEY MANOR GUEST HOME
Organization subpart
No
Provider details
NPI number
Authorized official
GINGER PO (CEO)
(949) 648-2737
Entity
Organization
Contact information
Practice address
6130 VINELAND AVE, NORTH HOLLYWOOD, CA 91606-4914
(818) 766-8161
(818) 643-8753
Mailing address
6130 VINELAND AVE, NORTH HOLLYWOOD, CA 91606-4914
(949) 648-2737
(949) 608-1588
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
06/07/2018
Last updated
03/26/2020
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