MEDICARE: VIEWCREST CONGREGATE LIVING

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	320700000X	Physical Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1558980896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIEWCREST CONGREGATE LIVING

Provider Business Mailing Address
First Line	:	7831 MELITA AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1820
Country	:	US
Telephone Number	:	818-800-0818
Fax Number	:	877-414-2183

Provider Business Practice Location Address
First Line	:	7831 MELITA AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1820
Country	:	US
Telephone Number	:	818-800-0818
Fax Number	:	877-414-2183

Authorized Official
Title or Position	:	CEO
Name	:	ARMEN OGANESYAN
Credential	:	CEO
Telephone Number	:	818-800-0818

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	04/15/2020

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