Provider Demographics
NPI:1629290853
Name:VENUS ADULT DAY HEALTH CARE CENTER, INC.
Entity type:Organization
Organization Name:VENUS ADULT DAY HEALTH CARE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHISHKERYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-843-7872
Mailing Address - Street 1:1634 N SAN FERNANDO BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4122
Mailing Address - Country:US
Mailing Address - Phone:818-843-7872
Mailing Address - Fax:818-843-7805
Practice Address - Street 1:1634 N SAN FERNANDO BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4122
Practice Address - Country:US
Practice Address - Phone:818-843-7872
Practice Address - Fax:818-843-7805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000810261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care