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General NPI Number Information
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NPI Number | 1871985523
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Entity Type | Organization
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Legal Business Name | OUR SWEET HOME, INC.
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 10150 MELVINE AVE.
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City | NORTHRIDGE
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State | CA
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Zip | 91324
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Country | US
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Telephone | 818-970-9586
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Fax |
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Provider Business Mailing Address
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Address Line | 10150 MELVIN AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-1022
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Country | US
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Telephone | 818-970-9586
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Fax |
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Authorized Official
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Title or Position | LICENSEE/ADMINISTRATOR
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Name | MRS. TINA ARUTYUNYAN
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Credential |
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Telephone | 818-970-9586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 197608083
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License Number State | CA
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