Mary Ellen Homes LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARY ELLEN HOMES LLC

Practice address

7752 Mary Ellen Ave
North Hollywood, CA 91605-1928

Phone

(818) 279-1415

NPI assigned

Apr 6, 2023

Last updated

Apr 6, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gohar Khachatryan

Title

Licensee

Phone

(818) 279-1415

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1518652460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7752 MARY ELLEN AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916051928",
            "telephone_number": "818-279-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7752 MARY ELLEN AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916051928",
            "telephone_number": "818-279-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ELLEN HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "KHACHATRYAN",
        "authorized_official_first_name": "GOHAR",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "818-279-1415"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.