Provider Demographics
NPI:1477206621
Name:SPRINGVILLE RANCH ADHC
Entity Type:Organization
Organization Name:SPRINGVILLE RANCH ADHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBR
Authorized Official - Prefix:
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSENYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-371-7611
Mailing Address - Street 1:416 ETON DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2942
Mailing Address - Country:US
Mailing Address - Phone:818-371-7611
Mailing Address - Fax:
Practice Address - Street 1:36400 CA-190
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:CA
Practice Address - Zip Code:93265
Practice Address - Country:US
Practice Address - Phone:818-371-7611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care