Organization
ROYAL CONGREGATE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSIE STA MARIA (PRESIDENT)
(818) 456-2464
Entity
Organization
Contact information
Practice address
7354 DE SOTO AVE, CANOGA PARK, CA 91303-1703
(818) 657-7309
Mailing address
5530 CORBIN AVE STE 112, TARZANA, CA 91356-6048
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/01/2018
Last updated
11/21/2018
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