Provider Demographics
NPI:1427418383
Name:ALL VALLEY CONGREGATE LIVING INC
Entity Type:Organization
Organization Name:ALL VALLEY CONGREGATE LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEREBRYANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-300-9396
Mailing Address - Street 1:17404 HORACE ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4719
Mailing Address - Country:US
Mailing Address - Phone:818-459-4995
Mailing Address - Fax:818-671-1868
Practice Address - Street 1:17404 HORACE ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4719
Practice Address - Country:US
Practice Address - Phone:818-459-4995
Practice Address - Fax:818-671-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities