Provider Demographics
NPI:1669022547
Name:CONTINUUM LIVING, LLC
Entity Type:Organization
Organization Name:CONTINUUM LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHU
Authorized Official - Middle Name:BALA
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:323-252-3782
Mailing Address - Street 1:382 N LEMON AVE STE 358
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2344
Mailing Address - Country:US
Mailing Address - Phone:323-252-3782
Mailing Address - Fax:323-259-1007
Practice Address - Street 1:24343 PAWNEE TRL
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-5033
Practice Address - Country:US
Practice Address - Phone:323-252-3782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility