Organization
DERANI CONGREGATE LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANI DAVIDAGAYAN (CEO)
(626) 733-1062
Entity
Organization
Contact information
Practice address
7344 ETIWANDA AVE, RESEDA, CA 91335-3103
(626) 733-1062
(818) 975-5534
Mailing address
7344 ETIWANDA AVE, RESEDA, CA 91335-3103
(626) 733-1062
(818) 975-5534
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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