Healthcare Provider Details
I. General information
NPI: 1134585318
Provider Name (Legal Business Name): BELLA VITA CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2016
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10030 HAYVENHURST AVE
NORTH HILLS CA
91343-1104
US
IV. Provider business mailing address
10030 HAYVENHURST AVE
NORTH HILLS CA
91343-1104
US
V. Phone/Fax
- Phone: 747-202-6776
- Fax: 818-350-4460
- Phone: 747-202-6776
- Fax: 818-350-4460
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSANNA
ARAKELYAN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 747-202-6776