Organization
KINGSLEY PLACE ADHC 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARMEN BASMADZHYAN (ADMINISTRATOR)
(213) 387-9097
Entity
Organization
Contact information
Practice address
1225 JAMES M. WOOD BLVD., LOS ANGELES, CA 90015-1231
(213) 387-9097
(213) 387-9098
Mailing address
1225 JAMES M. WOOD BLVD., LOS ANGELES, CA 90015-1231
(213) 387-9097
(213) 387-9098
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
060000907
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ADU70395F
—
CA
Enumeration date
04/16/2007
Last updated
01/18/2023
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