Healthcare Provider Details
I. General information
NPI: 1699571356
Provider Name (Legal Business Name): STAY HEALTHY COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11500 BURBANK BLVD
NORTH HOLLYWOOD CA
91601-2308
US
IV. Provider business mailing address
11500 BURBANK BLVD
NORTH HOLLYWOOD CA
91601-2308
US
V. Phone/Fax
- Phone: 818-599-9971
- Fax:
- Phone: 818-599-9971
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANAHIT
DJGALIAN
Title or Position: CEO
Credential:
Phone: 818-599-9971