Healthcare Provider Details

I. General information

NPI: 1629290853
Provider Name (Legal Business Name): VENUS ADULT DAY HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1634 N SAN FERNANDO BLVD
BURBANK CA
91504-4122
US

IV. Provider business mailing address

1634 N SAN FERNANDO BLVD
BURBANK CA
91504-4122
US

V. Phone/Fax

Practice location:
  • Phone: 818-843-7872
  • Fax: 818-843-7805
Mailing address:
  • Phone: 818-843-7872
  • Fax: 818-843-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number060000810
License Number StateCA

VIII. Authorized Official

Name: MARINE KESHISHKERYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-843-7872