Glen Park At Glendale - Mariposa St

NPI 1417132812 - Assisted Living Facility - 310400000X

NPI Details
NPI 1417132812
Enumeration Date 01/03/2008
Last Updated 01/08/2015
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name TILLMAN NMN TILLMAN
Position PRESIDENT
Phone (818) 242-9000
Fax (818) 242-3972
Practice Location
1220 MARIPOSA ST
GLEN PARK WEST RETIREMENT COMMUNITY INC
GLENDALE CA, 91205-3245, US
Phone (818) 242-9000
Fax (818) 242-3972
Business Location
1220 MARIPOSA ST
GLEN PARK WEST RETIREMENT COMMUNITY INC
GLENDALE CA, 91205-3245, US
Phone (818) 242-9000
Fax (818) 242-3972
Toxanomy
Taxonomy Code 310400000X
License State California
License Number 191222675
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According to our database, Glen Park At Glendale - Mariposa St NPI is 1417132812, taxonomy code is 310400000X and license number is 191222675, license state is located at California. Glen Park At Glendale - Mariposa St physically located at 1220 Mariposa St, Glendale CA, 91205-3245. NPI Number 1033115704 has the healthcare provider type.

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1417132812 NPI number is provided on an as is basis without warranty of any kind. 1417132812 is maintained by the National Plan & Provider Enumeration System. The contents of Glen Park At Glendale - Mariposa St are for informational purposes only.