Provider Demographics
NPI:1942414990
Name:GRAND ADULT HEALTH DAY CARE, INC.
Entity Type:Organization
Organization Name:GRAND ADULT HEALTH DAY CARE, INC.
Other - Org Name:GRAND ADULT DAY HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:POGOSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-344-3456
Mailing Address - Street 1:6752 WHITE OAK AVENUE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406
Mailing Address - Country:US
Mailing Address - Phone:818-344-3456
Mailing Address - Fax:818-344-3321
Practice Address - Street 1:6752 WHITE OAK AVENUE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406
Practice Address - Country:US
Practice Address - Phone:818-344-3456
Practice Address - Fax:818-344-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care