Provider Demographics
NPI: | 1760812101 |
---|---|
Name: | MONTROSE COMFORT LIVING AND CARE, INC |
Entity Type: | Organization |
Organization Name: | MONTROSE COMFORT LIVING AND CARE, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO/ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ARMEN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KARA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 818-330-9857 |
Mailing Address - Street 1: | 4339 BRIGGS AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | MONTROSE |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 91020-1107 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 818-330-9857 |
Mailing Address - Fax: | 818-330-9856 |
Practice Address - Street 1: | 4339 BRIGGS AVE |
Practice Address - Street 2: | |
Practice Address - City: | MONTROSE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 91020-1107 |
Practice Address - Country: | US |
Practice Address - Phone: | 818-330-9857 |
Practice Address - Fax: | 818-330-9856 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-11-21 |
Last Update Date: | 2020-06-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 314000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |