Healthcare Provider Details

I. General information

NPI: 1205030624
Provider Name (Legal Business Name): FIRST VENTURES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13310 RAMONA BLVD STE K
BALDWIN PARK CA
91706-3860
US

IV. Provider business mailing address

13310 RAMONA BLVD STE K
BALDWIN PARK CA
91706-3860
US

V. Phone/Fax

Practice location:
  • Phone: 626-960-9757
  • Fax: 626-960-5787
Mailing address:
  • Phone: 626-960-9757
  • Fax: 626-960-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. LINDA G FAJARDO
Title or Position: ADMINISTRATOR
Credential:
Phone: 626-960-9757