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General NPI Number Information
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NPI Number | 1003958356
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Entity Type | Organization
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Legal Business Name | ARARAT HOME OF LOS ANGELES, INC.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 2373 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041-1157
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Country | US
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Telephone | 323-256-8012
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Fax | 323-256-8146
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Provider Business Mailing Address
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Address Line | 2373 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041-1157
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Country | US
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Telephone | 323-256-8012
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Fax | 323-256-8146
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Authorized Official
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Title or Position | COO
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Name | MR. DERIK GHOOKASIAN
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Credential |
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Telephone | 323-256-8012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 970000045
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License Number State | CA
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