Organization Name: | FAMILY ADULT DAY HEALTHCARE |
NPI Number: | 1104976612 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPHINE CHAVEZ (ADMINISTRATOR) |
Mailing Address: | 2280 Lomita Blvd Lomita |
State: | CA US |
Postal Code: | 907171436 |
Phone Number: | 3106020123 |
Fax Number: | 3106020124 |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |