Provider Demographics
NPI:1669847240
Name:SAINT MARIAM CONGREGATE
Entity Type:Organization
Organization Name:SAINT MARIAM CONGREGATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIGRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVSEPYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-536-4777
Mailing Address - Street 1:13749 ALDERGROVE ST
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13749 ALDERGROVE ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1718
Practice Address - Country:US
Practice Address - Phone:818-536-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility