Healthcare Provider Details

I. General information

NPI: 1508638420
Provider Name (Legal Business Name): ENHANCED CARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5714 MCDONIE AVE
WOODLAND HILLS CA
91367-5535
US

IV. Provider business mailing address

3400 COTTAGE WAY, STE G2 #20819
SACRAMENTO CA
95825
US

V. Phone/Fax

Practice location:
  • Phone: 818-293-5283
  • Fax:
Mailing address:
  • Phone: 818-293-5283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN ZADOYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-293-5283