Provider Demographics
NPI:1477929628
Name:SEVILLE CIRCLE INC.
Entity type:Organization
Organization Name:SEVILLE CIRCLE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-496-1630
Mailing Address - Street 1:1900 GRISMER AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504
Mailing Address - Country:US
Mailing Address - Phone:818-843-3141
Mailing Address - Fax:818-843-5732
Practice Address - Street 1:1900 GRISMER AVE.
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504
Practice Address - Country:US
Practice Address - Phone:818-843-3141
Practice Address - Fax:818-843-5732
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEVILLE CIRCLE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)