Organization
JOLLYWOOD LIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISSA CHOW (CEO)
(323) 492-8053
Entity
Organization
Contact information
Practice address
1121 W EDGEWARE RD, LOS ANGELES, CA 90026-5168
(323) 492-8053
Mailing address
1121 W EDGEWARE RD, LOS ANGELES, CA 90026-5168
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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