Provider Demographics
NPI:1265431738
Name:OAKVIEW CONVALESCENT HOSP., INC
Entity type:Organization
Organization Name:OAKVIEW CONVALESCENT HOSP., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:626-828-8431
Mailing Address - Street 1:9166 TUJUNGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-3462
Mailing Address - Country:US
Mailing Address - Phone:818-352-4426
Mailing Address - Fax:818-951-5797
Practice Address - Street 1:9166 TUJUNGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-3462
Practice Address - Country:US
Practice Address - Phone:818-352-4426
Practice Address - Fax:818-951-5797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9200000052310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055360Medicaid
055360Medicare ID - Type Unspecified