Healthcare Provider Details

I. General information

NPI: 1639929912
Provider Name (Legal Business Name): OTRIUM CARE HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15933 RAYEN ST
NORTH HILLS CA
91343-4811
US

IV. Provider business mailing address

15933 RAYEN ST
NORTH HILLS CA
91343-4811
US

V. Phone/Fax

Practice location:
  • Phone: 310-404-3778
  • Fax:
Mailing address:
  • Phone: 310-404-3778
  • Fax: 323-909-0246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LEVON TUNYAN
Title or Position: CEO
Credential:
Phone: 323-909-0246