Provider Demographics
NPI:1174362305
Name:ARDENT SENIOR CARE, INC.
Entity type:Organization
Organization Name:ARDENT SENIOR CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROSANA
Authorized Official - Middle Name:BALDONADO
Authorized Official - Last Name:CASTRONUEVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-537-4508
Mailing Address - Street 1:201 MCCRAY ST STE 232A
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4111
Mailing Address - Country:US
Mailing Address - Phone:831-537-4508
Mailing Address - Fax:831-265-7003
Practice Address - Street 1:920 SUNNYSLOPE RD FL 2
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5784
Practice Address - Country:US
Practice Address - Phone:831-537-4508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)