Healthcare Provider Details

I. General information

NPI: 1164268140
Provider Name (Legal Business Name): GOLDEN STATE ADHC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S GARFIELD AVE
ALHAMBRA CA
91801-4441
US

IV. Provider business mailing address

900 S GARFIELD AVE
ALHAMBRA CA
91801-4441
US

V. Phone/Fax

Practice location:
  • Phone: 626-995-1412
  • Fax:
Mailing address:
  • Phone: 626-800-0003
  • Fax: 626-803-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ARMINE PETROSIAN
Title or Position: CEO
Credential: NP
Phone: 626-995-1412