Healthcare Provider Details

I. General information

NPI: 1407265309
Provider Name (Legal Business Name): ELDER DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 W MAIN ST
EL CENTRO CA
92243-2921
US

IV. Provider business mailing address

643 MAIN ST
BRAWLEY CA
92227-2547
US

V. Phone/Fax

Practice location:
  • Phone: 760-337-8393
  • Fax: 760-337-8449
Mailing address:
  • Phone: 760-344-4654
  • Fax: 760-344-4608

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: ELIZABETH TOSTE MACHADO
Title or Position: PRESIDENT
Credential:
Phone: 760-996-7913