Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Balboa Elderly Living Care Inc

Organization Assisted Living Facility · NPI 1255203840

Lake Balboa Elderly Living Care Inc is an Assisted Living Facility in Van Nuys, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

17221 Cantlay St
Van Nuys, CA 91406-2539
Phone: (424) 303-8478
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1255203840
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Levon Khostikyan — Ceo · (424) 303-8478
NPI enumeratedSeptember 22, 2025
Last updated in NPPESSeptember 22, 2025
Certification dateSeptember 22, 2025
Mailing address17221 Cantlay St, Van Nuys, CA 91406-2539

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