MEDICARE: SAFEWAY HOME FOR ELDERLY CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1033784202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFEWAY HOME FOR ELDERLY CARE

Provider Business Mailing Address
First Line	:	8808 ENFIELD AVE
Second Line	:
City	:	SHERWOOD FOREST
State	:	CA
Zip	:	91325-3131
Country	:	US
Telephone Number	:	818-601-6666
Fax Number	:	818-241-4242

Provider Business Practice Location Address
First Line	:	8808 ENFIELD AVE
Second Line	:
City	:	SHERWOOD FOREST
State	:	CA
Zip	:	91325-3131
Country	:	US
Telephone Number	:	818-601-6666
Fax Number	:	818-241-4242

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANNETTE ZARGARYAN
Credential	:
Telephone Number	:	818-601-6666

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	05/20/2021

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Directions to “SAFEWAY HOME FOR ELDERLY CARE ” Practice Location

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