Provider Demographics
NPI:1114957958
Name:SAN FERNANDO VALLEY ADULT DAY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SAN FERNANDO VALLEY ADULT DAY HEALTH CARE, LLC
Other - Org Name:SAN FERNANDO VALLEY ADULT DAY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:TROSTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-832-1418
Mailing Address - Street 1:10660 WHITE OAK AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5943
Mailing Address - Country:US
Mailing Address - Phone:818-832-1418
Mailing Address - Fax:818-832-1420
Practice Address - Street 1:10660 WHITE OAK AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5943
Practice Address - Country:US
Practice Address - Phone:818-832-1418
Practice Address - Fax:818-832-1420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services