Provider Demographics
NPI:1326584475
Name:MOBAR CARE
Entity Type:Organization
Organization Name:MOBAR CARE
Other - Org Name:PRIMROSE SENIOR CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MUBEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIMUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-387-2755
Mailing Address - Street 1:18636 CELTIC ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2708
Mailing Address - Country:US
Mailing Address - Phone:323-387-2755
Mailing Address - Fax:818-280-6938
Practice Address - Street 1:8107 DE SOTO AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4301
Practice Address - Country:US
Practice Address - Phone:323-387-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197609023310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility