PALMDALE CONGREGATE LIVING, INC.
NPI 1134510530
Skilled Nursing Facility in Palmdale, CA

Active since February 07, 2015CLIA 05D2117797 · Waiver
38702 12TH ST E, PALMDALE, CA 93550(818) 731-4664 Get Directions Write a Review

NPPES record last updated: February 7, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Palmdale Congregate Living, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PALMDALE CONGREGATE LIVING, INC. (NPI 1134510530) is a healthcare organization registered as a skilled nursing facility in Palmdale, California and active in the NPI registry since February 2015. The organization holds a CLIA Waiver certificate valid through August 22, 2026 and lists Mourad Mike Tokatlyan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1134510530
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePALMDALE CONGREGATE LIVING, INC.
Location Address38702 12TH ST EPalmdale, CA 93550-3990
Mailing Address38702 12th St EPalmdale, CA 93550-3990
Organization SubpartNo
Authorized OfficialMourad Mike TokatlyanCeo · (818) 753-4664
Enumeration DateFebruary 7, 2015
NPI 1134510530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
38702 12TH ST E, Palmdale, CA 93550

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2117797

Palmdale Congregate Living Inc. · Palmdale, CA
Active · expires Aug 22, 2026
CLIA Number05D2117797
Laboratory TypeCongregate Lvl Hlth S
Certificate Effective DateAugust 23, 2024
Certificate Expiration DateAugust 22, 2026
Laboratory DirectorDoddanna Krishna, MD
Laboratory Phone(818) 731-4664
Laboratory LocationPalmdale Congregate Living Inc.38702 12th St E, Palmdale, CA 93550
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Palmdale Congregate Living, Inc.'s NPI number?

The NPI number for Palmdale Congregate Living, Inc. is 1134510530. It was assigned to this organization in the NPPES registry on February 7, 2015.

Where is Palmdale Congregate Living, Inc. located?

Palmdale Congregate Living, Inc. is located at 38702 12th St E, Palmdale, CA 93550. The listed phone number is (818) 731-4664.

What is Palmdale Congregate Living, Inc.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Palmdale Congregate Living, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2117797) is associated with this NPI, valid through August 22, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Palmdale Congregate Living, Inc. was last updated on February 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.