Healthcare Provider Details

I. General information

NPI: 1063970549
Provider Name (Legal Business Name): SM MANAGEMENT GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11745 FIRESTONE BLVD
NORWALK CA
90650-8851
US

IV. Provider business mailing address

1046 GLEN ARBOR AVE
LOS ANGELES CA
90041-2518
US

V. Phone/Fax

Practice location:
  • Phone: 818-416-1119
  • Fax:
Mailing address:
  • Phone: 818-416-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SUZANA MIRZOYAN
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 818-416-1119