HANSEN COMMUNITY CARE NPI 1083205439

NPI Information

HANSEN COMMUNITY CARE is an intermediate care facility mentally retarded in Pacoima, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. HANSEN COMMUNITY CARE NPI is 1083205439. The provider is registered as an organization entity type.

The provider's business location address is:

12943 WINGO ST
PACOIMA, CA
ZIP 91331-156
Phone: (818) 203-7779

The provider's authorized official is Alex Arutunyan .
The authorized official title is Cfo/secretary and has the following contact phone number (818) 203-7779.

The CLIA number assigned to this NPI record is 05D2289392 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2021 and was last updated on 1/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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