Healthcare Provider Details

I. General information

NPI: 1609097229
Provider Name (Legal Business Name): FAMILY CARE ADHC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 COLDWATER CANYON AVE
NORTH HOLLYWOOD CA
91606-1113
US

IV. Provider business mailing address

6440 COLDWATER CANYON AVE
NORTH HOLLYWOOD CA
91606-1113
US

V. Phone/Fax

Practice location:
  • Phone: 818-762-0373
  • Fax: 818-762-0035
Mailing address:
  • Phone: 818-762-0373
  • Fax: 818-762-0035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number46973946
License Number StateCA

VIII. Authorized Official

Name: LEVON ARSENYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-489-0463