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General NPI Number Information
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NPI Number | 1609688746
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Entity Type | Organization
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Legal Business Name | MY LOVELY HOUSE INC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 13367 BLYTHE ST
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-1702
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Country | US
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Telephone | 818-292-7375
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Fax |
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Provider Business Mailing Address
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Address Line | 6606 VINELAND AVE APT 6
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City | N HOLLYWOOD
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State | CA
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Zip | 91606-2037
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Country | US
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Telephone | 310-666-3399
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ARMINE GRIGORYAN
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Credential |
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Telephone | 310-666-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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