Healthcare Provider Details

I. General information

NPI: 1194477893
Provider Name (Legal Business Name): VALLEY PARADISE CBAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31905 CASTAIC RD
CASTAIC CA
91384-3982
US

IV. Provider business mailing address

31905 CASTAIC RD
CASTAIC CA
91384-3982
US

V. Phone/Fax

Practice location:
  • Phone: 818-616-7027
  • Fax:
Mailing address:
  • Phone: 818-616-7027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRISTINE CHILINGIRIAN
Title or Position: PRESIDENT
Credential:
Phone: 213-261-9595