Provider Demographics
NPI:1780677088
Name:ARCADIA CONVALESCENT HOSPITAL, INC
Entity Type:Organization
Organization Name:ARCADIA CONVALESCENT HOSPITAL, INC
Other - Org Name:ARCADIA HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARIZIO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:626-445-2170
Mailing Address - Street 1:1601 S BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7930
Mailing Address - Country:US
Mailing Address - Phone:626-445-2170
Mailing Address - Fax:626-445-0338
Practice Address - Street 1:1601 S BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7930
Practice Address - Country:US
Practice Address - Phone:626-445-2170
Practice Address - Fax:626-445-0338
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCADIA CONVALESCENT HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-23
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22T18012FMedicaid
CA22T18012FMedicaid