MEDICARE: NARA'S RESIDENTIAL CARE INC

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1093365124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NARA'S RESIDENTIAL CARE INC

Provider Business Mailing Address
First Line	:	17520 ORNA DR
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-1328
Country	:	US
Telephone Number	:	818-396-2051
Fax Number	:

Provider Business Practice Location Address
First Line	:	17520 ORNA DR
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-1328
Country	:	US
Telephone Number	:	818-396-2051
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	NARINE HAKOBYAN
Credential	:
Telephone Number	:	818-396-2051

Provider Enumeration Date	:	09/20/2019
Last Update Date	:	09/20/2019

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