Healthcare Provider Details

I. General information

NPI: 1558950766
Provider Name (Legal Business Name): AURORA CONGREGATE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12706 BYRON AVE
GRANADA HILLS CA
91344-1351
US

IV. Provider business mailing address

12706 BYRON AVE
GRANADA HILLS CA
91344-1351
US

V. Phone/Fax

Practice location:
  • Phone: 818-257-1457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ANI MKRTCHYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-257-1457