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Organization

COURTYARD PLAZA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONAHUE GILBERT VANDERHIDER I M.S.G. (EXECUTIVE DIRECTOR)
(818) 780-5005
Entity
Organization

Contact information

Practice address
6951 LENNOX AVE, ADMINISTRATION, VAN NUYS, CA 91405-4034
(818) 780-5005
(818) 780-5176
Mailing address
6951 LENNOX AVE, ADMINISTRATION, VAN NUYS, CA 91405-4034
(818) 780-5005
(818) 780-5176

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
197603560
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6951LENNOX
CA
Enumeration date
04/02/2009
Last updated
04/02/2009
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