Provider Demographics
NPI:1407696982
Name:HEALING PATH RESIDENCE LLC
Entity type:Organization
Organization Name:HEALING PATH RESIDENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VARTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOROYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-966-0440
Mailing Address - Street 1:355 S GRAND AVE STE 2450
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90071-9500
Mailing Address - Country:US
Mailing Address - Phone:818-966-0440
Mailing Address - Fax:
Practice Address - Street 1:355 S GRAND AVE STE 2450
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90071-9500
Practice Address - Country:US
Practice Address - Phone:818-966-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health