MEDICARE: CRYSTAL ADULT DAY HEALTH CARE

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	:	1366373912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRYSTAL ADULT DAY HEALTH CARE

Provider Business Mailing Address
First Line	:	350 ARDEN AVE STE 100
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1110
Country	:	US
Telephone Number	:	747-724-9909
Fax Number	:	818-484-3888

Provider Business Practice Location Address
First Line	:	350 ARDEN AVE STE 100
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1110
Country	:	US
Telephone Number	:	747-724-9909
Fax Number	:	818-484-3888

Authorized Official
Title or Position	:	CEO
Name	:	ANUSH MNATSAKANYAN
Credential	:
Telephone Number	:	747-724-9909

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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