Provider Demographics
NPI:1659499945
Name:VALVERDE
Entity Type:Organization
Organization Name:VALVERDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RESIDENTIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMEDANINIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3108-458-0054
Mailing Address - Street 1:7600 VANALDEN AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1752
Mailing Address - Country:US
Mailing Address - Phone:818-342-3826
Mailing Address - Fax:818-342-1850
Practice Address - Street 1:7600 VANALDEN AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-1752
Practice Address - Country:US
Practice Address - Phone:818-342-3826
Practice Address - Fax:818-342-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities