Provider Demographics
NPI:1760685671
Name:ST. BARNABAS SENIOR CENTER OF LOS ANGELES
Entity Type:Organization
Organization Name:ST. BARNABAS SENIOR CENTER OF LOS ANGELES
Other - Org Name:ST. BARNABAS SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RIGO
Authorized Official - Middle Name:J
Authorized Official - Last Name:SABORIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSG
Authorized Official - Phone:213-388-4444
Mailing Address - Street 1:675 SOUTH CARONDELET STREET
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3309
Mailing Address - Country:US
Mailing Address - Phone:213-388-4444
Mailing Address - Fax:213-739-2972
Practice Address - Street 1:675 SOUTH CARONDELET STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3309
Practice Address - Country:US
Practice Address - Phone:213-388-4444
Practice Address - Fax:213-739-2972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000600261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care