MEDICARE: LHC ADHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1417635145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LHC ADHC

Provider Business Mailing Address
First Line	:	12211 MAGNOLIA ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-3318
Country	:	US
Telephone Number	:	714-725-4651
Fax Number	:

Provider Business Practice Location Address
First Line	:	12211 MAGNOLIA ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-3318
Country	:	US
Telephone Number	:	714-725-4651
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER/BOARD CHAIR
Name	:	MARIA JENNIFER NGUYEN
Credential	:
Telephone Number	:	213-569-3941

Provider Enumeration Date	:	07/11/2023
Last Update Date	:	07/11/2023

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