Provider Demographics
NPI:1164209821
Name:IN HOME CARE CENTER, INC.
Entity Type:Organization
Organization Name:IN HOME CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVLATYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-998-7577
Mailing Address - Street 1:9023 GAVIOTA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3012
Mailing Address - Country:US
Mailing Address - Phone:747-998-7577
Mailing Address - Fax:
Practice Address - Street 1:9023 GAVIOTA AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3012
Practice Address - Country:US
Practice Address - Phone:747-998-7577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility