Healthcare Provider Details

I. General information

NPI: 1659145076
Provider Name (Legal Business Name): EAGLE ROCK ADULT DAY HEALTH CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 COLORADO BLVD
LOS ANGELES CA
90041-2357
US

IV. Provider business mailing address

1205 E ELMWOOD AVE
BURBANK CA
91501-1615
US

V. Phone/Fax

Practice location:
  • Phone: 818-652-8990
  • Fax:
Mailing address:
  • Phone: 818-652-8990
  • 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: ALISA ABELIAN
Title or Position: OWNER
Credential:
Phone: 818-652-8990