Organization
GLEN PARK AT VALLEY VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TILLMAN PINK JR. (PRESIDENT)
(818) 769-6626
Entity
Organization
Contact information
Practice address
5527 LAUREL CANYON BLVD, VALLEY VILLAGE, CA 91607-2116
(818) 769-6626
(818) 761-2199
Mailing address
1220 MARIPOSA ST, LAUREL CANYON RETIREMENT CO GLEN PARK RETIREMENT, GLENDALE, CA 91205-3245
(818) 242-9000
(818) 242-3972
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
197603165
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RCF00032F
—
CA
Enumeration date
12/27/2007
Last updated
01/08/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us