Healthcare Provider Details

I. General information

NPI: 1265259915
Provider Name (Legal Business Name): REDWOOD ADHC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15121 MONTE ST
SYLMAR CA
91342-1348
US

IV. Provider business mailing address

15121 MONTE ST
SYLMAR CA
91342-1348
US

V. Phone/Fax

Practice location:
  • Phone: 707-220-2400
  • Fax: 707-220-2410
Mailing address:
  • Phone: 707-220-2400
  • Fax: 707-220-2410

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: VAROUJ HOVANNESSIAN
Title or Position: OWNER
Credential: RN
Phone: 707-220-2400