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General NPI Number Information
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NPI Number | 1184186827
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Entity Type | Organization
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Legal Business Name | SUNLIGHT CONGREGATE LIVING HEALTH FACILITY,INC.
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 7459 TAMPA AVE
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City | RESEDA
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State | CA
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Zip | 91335-2468
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Country | US
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Telephone | 818-450-5010
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Fax | 818-450-5040
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Provider Business Mailing Address
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Address Line | 7459 TAMPA AVE
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City | RESEDA
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State | CA
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Zip | 91335-2468
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Country | US
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Telephone | 818-450-5010
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Fax | 818-450-5040
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. GREGORY MIKITARIAN
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Credential | RN
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Telephone | 818-450-5010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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