Healthcare Provider Details

I. General information

NPI: 1437517166
Provider Name (Legal Business Name): ARISE CONGREGATE LIVING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12718 WEIDNER ST
PACOIMA CA
91331-1137
US

IV. Provider business mailing address

12718 WEIDNER ST
PACOIMA CA
91331-1137
US

V. Phone/Fax

Practice location:
  • Phone: 818-485-5356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ARMINE MARGARYAN
Title or Position: CEO
Credential:
Phone: 818-485-5356