Healthcare Provider Details

I. General information

NPI: 1538024203
Provider Name (Legal Business Name): A BEAUTIFUL VILLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7629 BEN AVE
NORTH HOLLYWOOD CA
91605-2729
US

IV. Provider business mailing address

7629 BEN AVE
NORTH HOLLYWOOD CA
91605-2729
US

V. Phone/Fax

Practice location:
  • Phone: 323-410-6886
  • Fax: 323-410-7706
Mailing address:
  • Phone: 323-410-6886
  • Fax: 323-410-7706

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: MARINE KHACHATRYAN
Title or Position: CEO
Credential:
Phone: 323-410-6886