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General NPI Number Information
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NPI Number | 1770285702
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Entity Type | Organization
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Legal Business Name | STARLIGHT FACILITY INC
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 7647 TUJUNGA AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-2937
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Country | US
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Telephone | 818-378-7069
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Fax |
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Provider Business Mailing Address
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Address Line | 7647 TUJUNGA AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-2937
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Country | US
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Telephone | 818-378-7069
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NELLI TADEVOSYAN
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Credential |
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Telephone | 818-378-7069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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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 | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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