Healthcare Provider Details

I. General information

NPI: 1932033867
Provider Name (Legal Business Name): PRIME CARE HEALTH RESIDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16318 CLYMER ST
GRANADA HILLS CA
91344-6817
US

IV. Provider business mailing address

16318 CLYMER ST
GRANADA HILLS CA
91344-6817
US

V. Phone/Fax

Practice location:
  • Phone: 323-537-6234
  • Fax:
Mailing address:
  • Phone: 323-537-6234
  • 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: SUSANNA HARUTYUNYAN
Title or Position: CEO
Credential: BSN, RN
Phone: 323-537-6234