Healthcare Provider Details

I. General information

NPI: 1225259922
Provider Name (Legal Business Name): ADULT DAY HEALTH CARE OF MAD RIVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 JANES RD
ARCATA CA
95521-4742
US

IV. Provider business mailing address

3800 JANES RD
ARCATA CA
95521-4742
US

V. Phone/Fax

Practice location:
  • Phone: 707-822-4866
  • Fax:
Mailing address:
  • Phone: 707-822-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number070000492
License Number StateCA

VIII. Authorized Official

Name: APRIL JOYCE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 707-822-4866