Provider Demographics
NPI:1336549203
Name:PURE HEART CONGREGATE LIVING FACILITY, INC.
Entity Type:Organization
Organization Name:PURE HEART CONGREGATE LIVING FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BADALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-516-6668
Mailing Address - Street 1:15918 NAPA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5838
Mailing Address - Country:US
Mailing Address - Phone:818-516-6668
Mailing Address - Fax:818-980-6020
Practice Address - Street 1:15918 NAPA ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5838
Practice Address - Country:US
Practice Address - Phone:818-516-6668
Practice Address - Fax:818-980-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility