Organization
AGE WELL CONGREGATE LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARKIS DOVLATYAN (CEO)
(310) 775-7264
Entity
Organization
Contact information
Practice address
15149 SYLVAN STREET, VAN NUYS, CA 91411
(310) 775-7264
Mailing address
15149 SYLVAN ST, VAN NUYS, CA 91411-1918
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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