Healthcare Provider Details
I. General information
NPI: 1366373912
Provider Name (Legal Business Name): CRYSTAL ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 ARDEN AVE STE 100
GLENDALE CA
91203-1110
US
IV. Provider business mailing address
350 ARDEN AVE STE 100
GLENDALE CA
91203-1110
US
V. Phone/Fax
- Phone: 747-724-9909
- Fax: 818-484-3888
- Phone: 747-724-9909
- Fax: 818-484-3888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANUSH
MNATSAKANYAN
Title or Position: CEO
Credential:
Phone: 747-724-9909