MEDICARE: FAMILY CARE ADHC 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	261QA0600X	Adult Day Care Clinic/Center	46973946	CA

General Provider Information

NPI Number	:	1609097229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE ADHC INC.

Provider Business Mailing Address
First Line	:	6440 COLDWATER CANYON AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-1113
Country	:	US
Telephone Number	:	818-762-0373
Fax Number	:	818-762-0035

Provider Business Practice Location Address
First Line	:	6440 COLDWATER CANYON AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-1113
Country	:	US
Telephone Number	:	818-762-0373
Fax Number	:	818-762-0035

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEVON ARSENYAN
Credential	:
Telephone Number	:	818-489-0463

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	08/22/2020

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