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Export Provider Record NPI 1417950163
Grancell Village Of The Los Angeles Jewish Home For The Aging
Organization Subpart: NO
Active
NPI Number1417950163
NPI TypeNPI-2 Organization
SpecialtyNursing Facility/Intermediate Care Facility
Provider Details
NPI1417950163
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2005-05-24
Last Updated2016-07-22
Authorized OfficialMary Forrest
Chief Executive Officer
Phone: 8187743208
Mailing Address7150 Tampa Ave
Reseda, CA 91335-3700
United States
Phone: (818) 774-3000
📍 View Map
Primary Practice Address7150 Tampa Ave
Reseda, CA 91335-3700
United States
Phone: (818) 774-3000
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCAZZT05900F-
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes313M00000X – Nursing Facility/Intermediate Care FacilityCA920000013
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About NPI 1417950163

Grancell Village Of The Los Angeles Jewish Home For The Aging is an organization registered in the CMS NPPES NPI Registry with NPI number 1417950163. The primary specialty listed is Nursing Facility/Intermediate Care Facility. The organization is located in Reseda, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-05-24. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1417950163?

NPI 1417950163 belongs to Grancell Village Of The Los Angeles Jewish Home For The Aging, a Nursing Facility/Intermediate Care Facility in Reseda, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1417950163 active?

The current status of NPI 1417950163 in the NPPES registry is Active. The record was last updated on 2016-07-22.

What specialty is NPI 1417950163?

NPI 1417950163 is classified under the taxonomy Nursing Facility/Intermediate Care Facility. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1417950163?

You can verify NPI 1417950163 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1417950163?

The primary practice address on file for NPI 1417950163 is 7150 Tampa Ave, Reseda, CA 91335-3700. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1417950163 issued?

NPI 1417950163 was first issued (enumerated) on 2005-05-24. The NPPES record was last updated on 2016-07-22.

Practice Location Map

Grancell Village Of The Los Angeles Jewish Home For The Aging is located at 7150 Tampa Ave, Reseda, CA. Use the map below to find directions or verify the practice location.

📍 7150 Tampa Ave, Reseda, CA 91335-3700  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Grancell Village Of The Los Angeles Jewish Home For The Aging. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1417950163. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Nursing Facility/Intermediate Care Facility920000013CA
Data Verified from CMS NPPES Last synced: 2026-08-29 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162