Provider Demographics
NPI:1316573793
Name:AAA ASSISTED LIVING ELDER CARE LLC
Entity Type:Organization
Organization Name:AAA ASSISTED LIVING ELDER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:GLORIA
Authorized Official - Last Name:LUCHERO
Authorized Official - Suffix:
Authorized Official - Credentials:BS DEGREE
Authorized Official - Phone:818-749-8711
Mailing Address - Street 1:17220 BALLINGER ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1930
Mailing Address - Country:US
Mailing Address - Phone:818-749-8711
Mailing Address - Fax:
Practice Address - Street 1:17220 BALLINGER ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1930
Practice Address - Country:US
Practice Address - Phone:818-749-8711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility