Provider Demographics
NPI:1225440043
Name:SENTINEL CONGREGATE LIVING INC
Entity Type:Organization
Organization Name:SENTINEL CONGREGATE LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISITNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDRAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-406-8767
Mailing Address - Street 1:18635 MALDEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4618
Mailing Address - Country:US
Mailing Address - Phone:888-406-8767
Mailing Address - Fax:818-671-1878
Practice Address - Street 1:18635 MALDEN ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4618
Practice Address - Country:US
Practice Address - Phone:888-406-8767
Practice Address - Fax:818-671-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities