Heavenly Manor Elderly Care LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

197608684 Issued in CA

Legal business name

HEAVENLY MANOR ELDERLY CARE LLC

Practice address

7708 Ethel Ave.
North Hollywood, CA 91605-0000

Phone

(818) 434-3089

Fax

(818) 765-7791

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Mariam Kratian

Title

Owner

Phone

(818) 434-3089

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1770953499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7708 ETHEL AVE.",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916050000",
            "telephone_number": "818-434-3089",
            "fax_number": "818-765-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7708 ETHEL AVE.",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916050000",
            "telephone_number": "818-434-3089",
            "fax_number": "818-765-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY MANOR ELDERLY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "KRATIAN",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-434-3089",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "197608684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.