Provider Demographics
NPI:1699011957
Name:ST ELIZABETH HOMES CLHF, INC.
Entity Type:Organization
Organization Name:ST ELIZABETH HOMES CLHF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VAHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELKONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-221-3669
Mailing Address - Street 1:8536 SALOMA AVE
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-2709
Mailing Address - Country:US
Mailing Address - Phone:818-221-3669
Mailing Address - Fax:888-558-1303
Practice Address - Street 1:8536 SALOMA AVE
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-2709
Practice Address - Country:US
Practice Address - Phone:818-221-3669
Practice Address - Fax:888-558-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities