Healthcare Provider Details

I. General information

NPI: 1760640239
Provider Name (Legal Business Name): OUR SWEET HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16017 BASSET ST
VAN NUYS CA
91406
US

IV. Provider business mailing address

8101 RHODES AVE
N HOLLYWOOD CA
91605
US

V. Phone/Fax

Practice location:
  • Phone: 323-735-5454
  • Fax: 323-735-5445
Mailing address:
  • Phone: 323-735-5454
  • Fax: 323-735-5445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: MRS. TINA ARUTYUNYAN
Title or Position: OWNER ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 818-970-9586