Healthcare Provider Details

I. General information

NPI: 1114822145
Provider Name (Legal Business Name): ELAN RCFE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14237 GAULT ST
VAN NUYS CA
91405-3214
US

IV. Provider business mailing address

14237 GAULT ST
VAN NUYS CA
91405-3214
US

V. Phone/Fax

Practice location:
  • Phone: 747-217-0708
  • Fax: 747-217-0710
Mailing address:
  • Phone: 747-217-0708
  • Fax: 747-217-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: EDUARD POGHOSYAN
Title or Position: CEO
Credential:
Phone: 323-250-5050