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General NPI Number Information
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NPI Number | 1003644873
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Entity Type | Organization
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Legal Business Name | CARING LOVE BOARDING CARE
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 5902 SHIRLEY AVE
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City | TARZANA
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State | CA
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Zip | 91356-1038
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Country | US
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Telephone | 818-370-2077
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Fax | 207-708-4971
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Provider Business Mailing Address
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Address Line | 5902 SHIRLEY AVE
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City | TARZANA
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State | CA
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Zip | 91356-1038
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Country | US
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Telephone | 818-370-2077
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Fax | 207-708-4971
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Authorized Official
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Title or Position | LICENSEE
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Name | MR. KHACHATUR GRIGORYAN
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Credential |
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Telephone | 818-312-8631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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