Organization
HEAVENLY MANOR ELDERLY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIAM KRATIAN (OWNER)
(818) 434-3089
Entity
Organization
Contact information
Practice address
7708 ETHEL AVE., NORTH HOLLYWOOD, CA 91605-0000
(818) 434-3089
(818) 765-7791
Mailing address
7708 ETHEL AVE., NORTH HOLLYWOOD, CA 91605-0000
(818) 434-3089
(818) 765-7791
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
197608684
CA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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