Provider Demographics
NPI:1548940489
Name:B AND B SENIOR VILLA INC.
Entity type:Organization
Organization Name:B AND B SENIOR VILLA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:GLADELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-367-6987
Mailing Address - Street 1:23019 VISTA DELGADO DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-2238
Mailing Address - Country:US
Mailing Address - Phone:661-367-6987
Mailing Address - Fax:
Practice Address - Street 1:23019 VISTA DELGADO DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354-2238
Practice Address - Country:US
Practice Address - Phone:661-367-6987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility