Provider Demographics
NPI:1639526759
Name:GAYNOR GARDENS, INC
Entity Type:Organization
Organization Name:GAYNOR GARDENS, INC
Other - Org Name:DEVONSHIRE GARDENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMAGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-437-5715
Mailing Address - Street 1:20128 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-3407
Mailing Address - Country:US
Mailing Address - Phone:818-772-0219
Mailing Address - Fax:
Practice Address - Street 1:20128 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-3407
Practice Address - Country:US
Practice Address - Phone:818-772-0219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility