Provider Demographics
NPI:1346421252
Name:SPIRIT OF HEALTH INC.
Entity type:Organization
Organization Name:SPIRIT OF HEALTH INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEKIMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-810-5084
Mailing Address - Street 1:2001 W 48TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062-2106
Mailing Address - Country:US
Mailing Address - Phone:323-299-4649
Mailing Address - Fax:323-299-4651
Practice Address - Street 1:2001 W 48TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-2106
Practice Address - Country:US
Practice Address - Phone:323-299-4649
Practice Address - Fax:323-299-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAADU70276F261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care