Provider Demographics
NPI:1104312313
Name:MAJESTICARE HEALTH AND REHAB CENTER OF MOORPARK
Entity type:Organization
Organization Name:MAJESTICARE HEALTH AND REHAB CENTER OF MOORPARK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEYANEH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARTANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-554-4769
Mailing Address - Street 1:4762 MAUREEN LN
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-7126
Mailing Address - Country:US
Mailing Address - Phone:805-517-1620
Mailing Address - Fax:805-517-1621
Practice Address - Street 1:4762 MAUREEN LN
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-7126
Practice Address - Country:US
Practice Address - Phone:805-517-1620
Practice Address - Fax:805-517-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility