Provider Demographics
NPI:1689414443
Name:PACIFIC SENIOR CARE
Entity type:Organization
Organization Name:PACIFIC SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIKTORYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYRAPETYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-516-8819
Mailing Address - Street 1:7731 ALDEA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE BALBOA
Mailing Address - State:CA
Mailing Address - Zip Code:91406-2108
Mailing Address - Country:US
Mailing Address - Phone:818-516-8819
Mailing Address - Fax:
Practice Address - Street 1:7731 ALDEA AVE
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-2108
Practice Address - Country:US
Practice Address - Phone:818-516-8819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility