Provider Demographics
NPI:1205648334
Name:AMY'S PARADISE HOME OF ANGELS INC
Entity type:Organization
Organization Name:AMY'S PARADISE HOME OF ANGELS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-666-3399
Mailing Address - Street 1:6606 VINELAND AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:N HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-2037
Mailing Address - Country:US
Mailing Address - Phone:310-666-3399
Mailing Address - Fax:
Practice Address - Street 1:11950 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:N HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-1536
Practice Address - Country:US
Practice Address - Phone:818-292-7375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities