Healthcare Provider Details

I. General information

NPI: 1255206470
Provider Name (Legal Business Name): SMILE ADHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66680 ACOMA AVENUE
DESERT HOT SPRINGS CA
92240
US

IV. Provider business mailing address

66680 ACOMA AVENUE
DESERT HOT SPRINGS CA
92240
US

V. Phone/Fax

Practice location:
  • Phone: 310-569-0009
  • Fax: 310-469-7474
Mailing address:
  • Phone: 310-569-0009
  • Fax: 310-469-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ROMAN LAL
Title or Position: PRESIDENT
Credential: MD
Phone: 310-569-0009