MEDICARE: EVERLASTING ADULT DAY CARE INC

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		CA

General Provider Information

NPI Number	:	1699873471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERLASTING ADULT DAY CARE INC

Provider Business Mailing Address
First Line	:	4515 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3214
Country	:	US
Telephone Number	:	323-433-3525
Fax Number	:	323-344-3501

Provider Business Practice Location Address
First Line	:	4515 EAGLE ROCK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3214
Country	:	US
Telephone Number	:	323-433-3525
Fax Number	:	323-344-3501

Authorized Official
Title or Position	:	CHAIRMAN OF THE BOARD
Name	:	MR. OSCAR LICTAOA JORNACION
Credential	:	CPA MBA
Telephone Number	:	323-433-3521

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1669601415 — VITAL MEDICAL SUPPLY INC.
Practice Location Address:

4515 EAGLE ROCK BLVD , SUITE 145C
LOS ANGELES, CA
90041-3214

Practice Phone: 323-550-8888
Practice Fax: 323-550-8881

1104123652 — PROHEALTH MEDICAL SUPPLY INC
Practice Location Address:

4509 EAGLE ROCK BLVD , STE B
LOS ANGELES, CA
90041-3214

Practice Phone: 323-255-3504
Practice Fax: 323-255-3504

1124433859 — CARE PROVIDER SERVICE
Practice Location Address:

4509 EAGLE ROCK BLVD
LOS ANGELES, CA
90041-3214

Practice Phone: 323-478-7385
Practice Fax: 323-372-3895

1184433369 — MEDOPS LLC
Practice Location Address:

4525 EAGLE ROCK BLVD
EAGLE ROCK, CA
90041-3214

Practice Phone: 818-846-4469
Practice Fax:

1184778631 — MARGARET DEACY LCSW
Practice Location Address:

3214 KELTON AVE
LOS ANGELES, CA
90034-3002

Practice Phone: 310-490-5968
Practice Fax:

1770612152 — JUN YOUNG KIM
Practice Location Address:

1020 S BRONSON AVE
LOS ANGELES, CA
90019-3214

Practice Phone: 323-936-9330
Practice Fax:

Directions to “EVERLASTING ADULT DAY CARE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.