Provider Demographics
NPI:1356119358
Name:ECLIPSE SENIOR CARE INC
Entity type:Organization
Organization Name:ECLIPSE SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NERSES
Authorized Official - Middle Name:
Authorized Official - Last Name:DISHOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-590-7362
Mailing Address - Street 1:7045 BECKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3818
Mailing Address - Country:US
Mailing Address - Phone:818-590-7362
Mailing Address - Fax:
Practice Address - Street 1:7045 BECKFORD AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3818
Practice Address - Country:US
Practice Address - Phone:818-590-7362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility