MEDICARE: REDWOOD ADHC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1265259915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDWOOD ADHC INC

Provider Business Mailing Address
First Line	:	15121 MONTE ST
Second Line	:
City	:	SYLMAR
State	:	CA
Zip	:	91342-1348
Country	:	US
Telephone Number	:	707-220-2400
Fax Number	:	707-220-2410

Provider Business Practice Location Address
First Line	:	15121 MONTE ST
Second Line	:
City	:	SYLMAR
State	:	CA
Zip	:	91342-1348
Country	:	US
Telephone Number	:	707-220-2400
Fax Number	:	707-220-2410

Authorized Official
Title or Position	:	OWNER
Name	:	VAROUJ HOVANNESSIAN
Credential	:	RN
Telephone Number	:	707-220-2400

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	09/24/2024

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Directions to “REDWOOD ADHC INC ” Practice Location

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