Provider Demographics
NPI:1447534979
Name:MCBEAN ENTERPRISES INCORPORATED
Entity type:Organization
Organization Name:MCBEAN ENTERPRISES INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-633-0750
Mailing Address - Street 1:17050 CHATSWORTH ST
Mailing Address - Street 2:SUITE 223
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-7818
Mailing Address - Country:US
Mailing Address - Phone:818-633-0750
Mailing Address - Fax:818-363-6600
Practice Address - Street 1:17050 CHATSWORTH ST
Practice Address - Street 2:SUITE 223
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-7818
Practice Address - Country:US
Practice Address - Phone:818-633-0750
Practice Address - Fax:818-363-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001038251E00000X
CA55000191251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550001991OtherDHS
CA550001991OtherDHS