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General NPI Number Information
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NPI Number | 1437574894
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Entity Type | Organization
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Legal Business Name | VISTA CARE HOME INC.
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 02/21/2014
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Provider Practice Location Address
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Address Line | 10949 BURNET AVE
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City | MISSION HILLS
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State | CA
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Zip | 91345-1505
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Country | US
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Telephone | 818-361-4999
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Fax | 818-361-1666
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Provider Business Mailing Address
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Address Line | 10949 BURNET AVE
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City | MISSION HILLS
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State | CA
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Zip | 91345-1505
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Country | US
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Telephone | 818-361-4999
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Fax | 818-361-1666
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS ELIZA MARTIROSYAN
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Credential |
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Telephone | 626-926-4303
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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 | 550002566
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License Number State | CA
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