Provider Demographics
NPI:1821579640
Name:SNH CALI TENANT LLC
Entity Type:Organization
Organization Name:SNH CALI TENANT LLC
Other - Org Name:SOMERFORD PLACE OF NORTHRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:F
Authorized Official - Last Name:MINTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-8104
Mailing Address - Street 1:255 WASHINGTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1634
Mailing Address - Country:US
Mailing Address - Phone:617-796-8350
Mailing Address - Fax:
Practice Address - Street 1:8700 LINDLEY AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-3032
Practice Address - Country:US
Practice Address - Phone:818-886-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SNH CALI TENANT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility