Provider Demographics
NPI:1982164851
Name:TRIUMPHANT ELDERLY CARE LLC
Entity Type:Organization
Organization Name:TRIUMPHANT ELDERLY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-205-3977
Mailing Address - Street 1:8106 LOMA VERDE AVE
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4306
Mailing Address - Country:US
Mailing Address - Phone:818-205-3977
Mailing Address - Fax:
Practice Address - Street 1:8106 LOMA VERDE AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4306
Practice Address - Country:US
Practice Address - Phone:818-205-3977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility