MEDICARE: WELLBE HOME 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	3104A0625X	Assisted Living Facility (Mental Illness)
2	310400000X	Assisted Living Facility	197609307	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	197609656	OTHER	CA	DEPARTMENT OF SOCIAL SERVICES (COMMUNITY CARE LICENSING) RCFE
2	197609307	OTHER	CA	DEPARTMENT OF SOCIAL SERVICES (COMMUNITY CARE LICENSING ) RCF
3	195850280	OTHER	CA	DEPARTMENT OF SOCIAL SERVICES (COMMUNITY CARE LICENSING ) RCFE

General Provider Information

NPI Number	:	1215446109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLBE HOME INC

Provider Business Mailing Address
First Line	:	6325 BEEMAN AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12950 HAYNES ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-1022
Country	:	US
Telephone Number	:	818-414-0005
Fax Number	:	855-683-8256

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	VAHE MKRTCHIAN
Credential	:
Telephone Number	:	818-414-0005

Provider Enumeration Date	:	09/24/2017
Last Update Date	:	12/30/2024

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Directions to “WELLBE HOME INC ” Practice Location

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