Provider Demographics
NPI:1699536383
Name:NORTH RESIDENTIAL CARE INC
Entity type:Organization
Organization Name:NORTH RESIDENTIAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURGARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-404-0290
Mailing Address - Street 1:7846 AGNES AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-2412
Mailing Address - Country:US
Mailing Address - Phone:818-404-0290
Mailing Address - Fax:
Practice Address - Street 1:7846 AGNES AVE
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-2412
Practice Address - Country:US
Practice Address - Phone:818-404-0290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility