Provider Demographics
NPI:1184482440
Name:GLEN PARK AT OJAI
Entity type:Organization
Organization Name:GLEN PARK AT OJAI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-296-4646
Mailing Address - Street 1:1220 MARIPOSA ST # 202
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-3254
Mailing Address - Country:US
Mailing Address - Phone:818-296-4646
Mailing Address - Fax:
Practice Address - Street 1:225 N LOMITA AVE
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-1541
Practice Address - Country:US
Practice Address - Phone:818-296-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility