Organization
WHITE OAK CONGREGATE LIVING FACILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIA VITTE (ADMINISTRATOR)
(310) 272-6666
Entity
Organization
Contact information
Practice address
9301 WHITE OAK AVE, NORTHRIDGE, CA 91325-2336
(818) 885-1135
(818) 885-1173
Mailing address
11847 BALBOA BLVD, GRANADA HILLS, CA 91344-2754
(310) 272-6666
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
311Z00000X
Custodial Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
320700000X
Physical Disabilities Residential Treatment Facility
550003205
CA
Other
Enumeration date
10/27/2015
Last updated
12/12/2017
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