Healthcare Provider Details
I. General information
NPI: 1578808515
Provider Name (Legal Business Name): HOME OF COMPASSION, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2012
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13276 TERRA BELLA ST
PACOIMA CA
91331-3105
US
IV. Provider business mailing address
13276 TERRA BELLA ST
PACOIMA CA
91331-3105
US
V. Phone/Fax
- Phone: 818-554-4769
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320700000X |
| Taxonomy | Physical Disabilities Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEYANEH
VARTANIAN
Title or Position: OWNER
Credential:
Phone: 818-554-4769