Provider Demographics
NPI:1215446109
Name:WELLBE HOME INC
Entity type:Organization
Organization Name:WELLBE HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VAHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MKRTCHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-414-0005
Mailing Address - Street 1:6325 BEEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12950 HAYNES ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1022
Practice Address - Country:US
Practice Address - Phone:818-414-0005
Practice Address - Fax:855-683-8256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-24
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197609307310400000X
3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197609656OtherDEPARTMENT OF SOCIAL SERVICES (COMMUNITY CARE LICENSING) RCFE
CA197609307OtherDEPARTMENT OF SOCIAL SERVICES (COMMUNITY CARE LICENSING ) RCF
CA195850280OtherDEPARTMENT OF SOCIAL SERVICES (COMMUNITY CARE LICENSING ) RCFE