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General NPI Number Information
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NPI Number | 1952646572
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Entity Type | Organization
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Legal Business Name | SOCHI COMMUNITY BASED ADULT SERVICES INC,
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 10/03/2015
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Provider Practice Location Address
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Address Line | 4414 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90029-2014
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Country | US
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Telephone | 818-903-0137
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Fax | 818-646-1313
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Provider Business Mailing Address
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Address Line | 1140 WINCHESTER AVE SUITE 23
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City | GLENDALE
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State | CA
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Zip | 91201-3514
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Country | US
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Telephone | 818-903-0137
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Fax | 818-646-1313
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Authorized Official
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Title or Position | PRESIDENT/TREASURER
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Name | MR. VAHAN VICTOR MARUKYAN
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Credential |
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Telephone | 818-903-0137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | CA
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