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General NPI Number Information
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NPI Number | 1194119081
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Entity Type | Organization
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Legal Business Name | SOTO VILLA INC.
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 6447 BABCOCK AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-2306
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Country | US
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Telephone | 818-821-1126
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Fax | 818-821-1126
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Provider Business Mailing Address
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Address Line | 6447 BABCOCK AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-2306
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Country | US
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Telephone | 818-821-1126
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Fax | 818-821-1126
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. ARSEN BEREMESH
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Credential | MHA
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Telephone | 323-422-1480
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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 | 197608823
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License Number State | CA
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