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General NPI Number Information
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NPI Number | 1215446109
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Entity Type | Organization
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Legal Business Name | WELLBE HOME INC
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Dates
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Enumeration Date | 09/24/2017
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 12950 HAYNES ST
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-1022
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Country | US
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Telephone | 818-414-0005
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Fax | 855-683-8256
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Provider Business Mailing Address
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Address Line | 6325 BEEMAN AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VAHE MKRTCHIAN
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Credential |
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Telephone | 818-414-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 197609307
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License Number State | CA
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