Healthcare Provider Details

I. General information

NPI: 1023589116
Provider Name (Legal Business Name): MAYWOOD ADULT DAY HEALTH CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5351 1/2 ATLANTIC BLVD
MAYWOOD CA
90270-2426
US

IV. Provider business mailing address

5351 1/2 ATLANTIC BLVD
MAYWOOD CA
90270-2426
US

V. Phone/Fax

Practice location:
  • Phone: 818-618-8456
  • Fax:
Mailing address:
  • Phone:
  • 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: TIGRAN GARABEDYAN
Title or Position: CEO
Credential:
Phone: 818-618-8456