- Enrollment id
- O20160803003257
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1477555472
- Multiple npi flag
- N
- Ccn
- 555579
- Associate id
- 7012136542
- Organization name
- ARARAT HOME OF LOS ANGELES INC.
- Doing business as name
- ARARAT NURSING FACILITY
- Incorporation date
- 1984-01-03
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- ARARAT NURSING FACILITY
- Address line 1
- 15099 MISSION HILLS RD
- City
- MISSION HILLS
- State
- CA
- Zip code
- 913451102