Healthcare Provider Details

I. General information

NPI: 1184820524
Provider Name (Legal Business Name): VINELAND ADULT DAY HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5629 VINELAND AVE
NORTH HOLLYWOOD CA
91601-2029
US

IV. Provider business mailing address

5629 VINELAND AVE
NORTH HOLLYWOOD CA
91601-2029
US

V. Phone/Fax

Practice location:
  • Phone: 818-753-0714
  • Fax: 818-753-0916
Mailing address:
  • Phone: 818-753-0714
  • Fax: 818-753-0916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. NARA KAZARIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 18187530714