Provider Demographics
NPI:1154759207
Name:THE COMMUNITY HOME
Entity type:Organization
Organization Name:THE COMMUNITY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSKANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-302-3956
Mailing Address - Street 1:12244 COMMUNITY ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3807
Mailing Address - Country:US
Mailing Address - Phone:323-302-3956
Mailing Address - Fax:
Practice Address - Street 1:12244 COMMUNITY ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3807
Practice Address - Country:US
Practice Address - Phone:323-302-3956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility