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General NPI Number Information
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NPI Number | 1780118554
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Entity Type | Organization
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Legal Business Name | ADASTRA HEALTH CARE, INC
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 20453 ELKWOOD ST.
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City | WINNETKA
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State | CA
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Zip | 91306-2233
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Country | US
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Telephone | 818-993-1440
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Fax | 818-993-1449
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Provider Business Mailing Address
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Address Line | 20453 ELKWOOD ST.
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City | WINNETKA
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State | CA
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Zip | 91306-2233
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Country | US
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Telephone | 818-993-1440
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Fax | 818-993-1449
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Authorized Official
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Title or Position | CEO, PRESIDENT
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Name | MS. SUSANNA ARAKELYAN
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Credential |
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Telephone | 818-993-1440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 550003791
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License Number State | CA
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