Provider Demographics
NPI:1205689833
Name:JUST LIKE HOME II RCFE
Entity type:Organization
Organization Name:JUST LIKE HOME II RCFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:MARAT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-457-7727
Mailing Address - Street 1:13524 CHANDLER BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5231
Mailing Address - Country:US
Mailing Address - Phone:818-457-7727
Mailing Address - Fax:
Practice Address - Street 1:13524 CHANDLER BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5231
Practice Address - Country:US
Practice Address - Phone:818-457-7727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility