MEDICARE: DREAM CARE FACILITY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1376241356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAM CARE FACILITY INC

Provider Business Mailing Address
First Line	:	9849 CANEDO AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-1808
Country	:	US
Telephone Number	:	947-777-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	9849 CANEDO AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-1808
Country	:	US
Telephone Number	:	947-777-0770
Fax Number	:

Authorized Official
Title or Position	:	LICENSEE
Name	:	GEVORG GHOSALMYAN
Credential	:
Telephone Number	:	947-777-0770

Provider Enumeration Date	:	02/20/2023
Last Update Date	:	02/20/2023

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