Provider Demographics
NPI:1518775683
Name:G&A BOARDING CARE
Entity type:Organization
Organization Name:G&A BOARDING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-377-1116
Mailing Address - Street 1:7001 GARDEN GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4537
Mailing Address - Country:US
Mailing Address - Phone:818-377-1116
Mailing Address - Fax:
Practice Address - Street 1:7001 GARDEN GROVE AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4537
Practice Address - Country:US
Practice Address - Phone:818-377-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:G&A BOARDING CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility