Provider Demographics
NPI:1013121763
Name:SUNSHINE ADULT DAY HEALTH CARE CENTER INC.
Entity Type:Organization
Organization Name:SUNSHINE ADULT DAY HEALTH CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANAIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-988-7779
Mailing Address - Street 1:6939 VAN NUYS
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405
Mailing Address - Country:US
Mailing Address - Phone:818-988-7779
Mailing Address - Fax:
Practice Address - Street 1:6939 VAN NUYS
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-988-7779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70240FOtherMEDICAL