Healthcare Provider Details
I. General information
NPI: 1326235532
Provider Name (Legal Business Name): FRIENDLY ADHC 2
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10858 OXNARD ST
NORTH HOLLYWOOD CA
91606-5021
US
IV. Provider business mailing address
10858 OXNARD ST
NORTH HOLLYWOOD CA
91606-5021
US
V. Phone/Fax
- Phone: 818-509-1619
- Fax: 818-509-1623
- Phone: 818-509-1619
- Fax: 818-509-1623
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
ALVINA
TENEKEDJIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-353-3224