Organization
SUPREME RECUPERATIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEVORG GRIGORYAN (CEO)
(818) 322-0098
Entity
Organization
Contact information
Practice address
10462 YARMOUTH AVE, GRANADA HILLS, CA 91344-5932
(818) 322-0098
(818) 322-0089
Mailing address
10462 YARMOUTH AVE, GRANADA HILLS, CA 91344-5932
(818) 322-0098
(818) 322-0089
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/06/2023
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