Provider Demographics
NPI:1780843839
Name:CYNTHIA REED
Entity Type:Organization
Organization Name:CYNTHIA REED
Other - Org Name:BRIANAS VILLA INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-299-9604
Mailing Address - Street 1:6106 SOUTH LABREA AVENUE
Mailing Address - Street 2:SAME AS ABOVE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1822
Mailing Address - Country:US
Mailing Address - Phone:323-299-9604
Mailing Address - Fax:323-298-9605
Practice Address - Street 1:6106 S LA BREA AVE
Practice Address - Street 2:SAME AS ABOVE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90056-1822
Practice Address - Country:US
Practice Address - Phone:323-299-9604
Practice Address - Fax:323-298-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA198205366310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility