Provider Demographics
NPI:1497129845
Name:PARRADO INC.
Entity Type:Organization
Organization Name:PARRADO INC.
Other - Org Name:GOLDEN STATE MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-496-1630
Mailing Address - Street 1:1900 GRISMER AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3623
Mailing Address - Country:US
Mailing Address - Phone:818-843-3141
Mailing Address - Fax:
Practice Address - Street 1:14060 ASTORIA ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-2949
Practice Address - Country:US
Practice Address - Phone:818-367-1947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197606508310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility