MEDICARE: LAND OF PEACE 1

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	:	1619522992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAND OF PEACE 1

Provider Business Mailing Address
First Line	:	6624 SALE AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-3628
Country	:	US
Telephone Number	:	818-917-7211
Fax Number	:

Provider Business Practice Location Address
First Line	:	6624 SALE AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-3628
Country	:	US
Telephone Number	:	818-917-7211
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SONA MURADYAN
Credential	:
Telephone Number	:	818-917-7211

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	08/09/2019

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Directions to “LAND OF PEACE 1 ” Practice Location

Language	Start Address	Practice Location

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