Healthcare Provider Details

I. General information

NPI: 1265590657
Provider Name (Legal Business Name): NEW SUNRISE ADULT DAY HEALTH CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 RESEDA BLVD
NORTHRIDGE CA
91324-2926
US

IV. Provider business mailing address

9350 RESEDA BLVD
NORTHRIDGE CA
91324-2926
US

V. Phone/Fax

Practice location:
  • Phone: 818-101-0010
  • Fax: 818-701-0090
Mailing address:
  • Phone: 818-101-0010
  • Fax: 818-701-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number060000931
License Number StateCA

VIII. Authorized Official

Name: MS. AIDA KHRIMIAN
Title or Position: ADMINISTRATOR
Credential: MA
Phone: 818-701-0010