Healthcare Provider Details

I. General information

NPI: 1417880170
Provider Name (Legal Business Name): LIBERTY BOARDING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14421 COHASSET ST
VAN NUYS CA
91405-1431
US

IV. Provider business mailing address

14421 COHASSET ST
VAN NUYS CA
91405-1431
US

V. Phone/Fax

Practice location:
  • Phone: 818-233-3923
  • Fax: 818-475-5127
Mailing address:
  • Phone: 818-233-3923
  • Fax: 818-475-5127

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: HEGHINE KARAPETYAN
Title or Position: CEO
Credential:
Phone: 818-233-3923