Healthcare Provider Details

I. General information

NPI: 1124549829
Provider Name (Legal Business Name): KERN CONGREGATE FACILITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 CHRISTMAS TREE LN
BAKERSFIELD CA
93306
US

IV. Provider business mailing address

4803 CHRISTMAS TREE LN
BAKERSFIELD CA
93306-1767
US

V. Phone/Fax

Practice location:
  • Phone: 661-262-3272
  • Fax: 661-843-1016
Mailing address:
  • Phone: 661-262-3272
  • Fax: 661-843-1016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ASHKHEN GRIGORYAN
Title or Position: CEO
Credential:
Phone: 661-262-3272