Organization
RESEDA HORIZONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSCHELL ASHLEY (RESIDENTIAL ADMINISTRATOR)
(818) 894-9301
Entity
Organization
Contact information
Practice address
17831 SAN JOSE ST, GRANADA HILLS, CA 91344-5925
(818) 894-9301
(818) 894-8841
Mailing address
15725 PARTHENIA ST, NORTH HILLS, CA 91343-4913
(818) 894-9301
(818) 894-8841
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
9600001456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC61056F
—
CA
Enumeration date
04/20/2007
Last updated
08/22/2020
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