Organization
JMI VENTURES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY ILLENBERGER (LICENSEE)
(818) 325-6870
Entity
Organization
Contact information
Practice address
21709 RODAX ST, CANOGA PARK, CA 91304-2536
(818) 325-6870
Mailing address
21709 RODAX ST, CANOGA PARK, CA 91304-2536
(818) 325-6870
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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