Healthcare Provider Details

I. General information

NPI: 1194458059
Provider Name (Legal Business Name): TEHACHAPI ADHC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W F ST
TEHACHAPI CA
93561-1613
US

IV. Provider business mailing address

123 W F ST
TEHACHAPI CA
93561-1613
US

V. Phone/Fax

Practice location:
  • Phone: 661-823-4640
  • Fax:
Mailing address:
  • Phone: 661-823-4640
  • 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: LILLY INGA ARUTYUNYAN
Title or Position: CEO
Credential:
Phone: 818-266-7465