Provider Demographics
NPI:1083205439
Name:HANSEN COMMUNITY CARE
Entity Type:Organization
Organization Name:HANSEN COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUTUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-203-7779
Mailing Address - Street 1:12943 WINGO ST
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-4156
Mailing Address - Country:US
Mailing Address - Phone:818-203-7779
Mailing Address - Fax:
Practice Address - Street 1:12943 WINGO ST
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-4156
Practice Address - Country:US
Practice Address - Phone:818-203-7779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities