MEDICARE: HEART & HOME BOARD AND CARE II 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	:	1487517215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART & HOME BOARD AND CARE II INC

Provider Business Mailing Address
First Line	:	17803 LOS ALIMOS ST
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-4512
Country	:	US
Telephone Number	:	301-800-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	17803 LOS ALIMOS ST
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-4512
Country	:	US
Telephone Number	:	301-800-0808
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ZARUHI ATAYAN
Credential	:
Telephone Number	:	301-800-0808

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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