NPI 1053689257 · live from the CMS NPI Registry
Freshpath Healthcare Services
Assisted Living Facility in North Hollywood, CA. National Provider Identifier 1053689257, active.
NPI record
| NPI | 1053689257 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Assisted Living Facility 310400000X |
| Practice location | 11311 Morrison St Apt 207, North Hollywood, CA 91601 |
| Practice phone | 818-485-9182 |
| Mailing address | 231 Sierra Dr Se Suite 4, Albuquerque, NM 87108 |
| Enumerated | December 2, 2011 |
| Last updated | February 21, 2023 |
| Authorized official | Detro Wilkins, Chief Executive Officer |
| Other names | Fpm Colt C; Freshpath Healthcare Services |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based | 251G00000X | — |
| Assisted Living Facility primary | 310400000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.