MEDICARE: SOCIALLY ORIENTED UNITED LIVING 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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1629951629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIALLY ORIENTED UNITED LIVING INC.

Provider Business Mailing Address
First Line	:	145 S FAIRFAX AVE STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2186
Country	:	US
Telephone Number	:	855-669-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	7110 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-5249
Country	:	US
Telephone Number	:	855-669-1900
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED REPRESENTATIVE
Name	:	ROMAN ROZHANSKY
Credential	:
Telephone Number	:	855-669-1900

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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