Healthcare Provider Details

I. General information

NPI: 1932022472
Provider Name (Legal Business Name): ALEEN AODIS HAROUTUNIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14941 W DAHLIA DR
SURPRISE AZ
85379-5944
US

IV. Provider business mailing address

14941 W DAHLIA DR
SURPRISE AZ
85379-5944
US

V. Phone/Fax

Practice location:
  • Phone: 818-641-9879
  • Fax:
Mailing address:
  • Phone: 818-641-9879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberAL8883H
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: