Provider Demographics
NPI:1386401388
Name:ADAPTIVE, LLC
Entity type:Organization
Organization Name:ADAPTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ASADOORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-588-9785
Mailing Address - Street 1:1660 ARD EEVIN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1660 ARD EEVIN AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202
Practice Address - Country:US
Practice Address - Phone:818-588-9785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAPTIVE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies