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General NPI Number Information
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NPI Number | 1942024112
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Entity Type | Organization
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Legal Business Name | ST LABRE RC INC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 8225 BEN AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-1514
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Country | US
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Telephone | 747-900-3572
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Fax |
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Provider Business Mailing Address
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Address Line | 8225 BEN AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-1514
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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 | OWNER
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Name | ELENI MAKARYAN
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Credential |
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Telephone | 747-900-3617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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