Provider Demographics
NPI:1154839264
Name:ELITE CBAS CENTER, INC.
Entity Type:Organization
Organization Name:ELITE CBAS CENTER, INC.
Other - Org Name:ELITE CBAS CENTER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHOREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DICHIGRIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-927-4344
Mailing Address - Street 1:12825 VANOWEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-5219
Mailing Address - Country:US
Mailing Address - Phone:818-924-4344
Mailing Address - Fax:818-927-4345
Practice Address - Street 1:12825 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-5219
Practice Address - Country:US
Practice Address - Phone:818-927-4344
Practice Address - Fax:818-927-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care