Organization
FENTON VILLA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARO MANVELIAN (CEO)
(818) 925-5959
Entity
Organization
Contact information
Practice address
13863 FENTON AVE, SYLMAR, CA 91342-1670
(818) 925-5959
(818) 670-7868
Mailing address
2708 FOOTHILL BLVD, SUITE 345, LA CRESCENTA, CA 91214-3516
(818) 925-5959
(818) 670-7868
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
550002854
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750634903
—
CA
Enumeration date
10/24/2012
Last updated
06/09/2016
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