Healthcare Provider Details

I. General information

NPI: 1093807661
Provider Name (Legal Business Name): ALZHEIMER'S FAMILY SERVICES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9451 INDIANAPOLIS AVE
HUNTINGTON BEACH CA
92646-5955
US

IV. Provider business mailing address

9451 INDIANAPOLIS AVE
HUNTINGTON BEACH CA
92646-5955
US

V. Phone/Fax

Practice location:
  • Phone: 714-593-9630
  • Fax: 714-593-9632
Mailing address:
  • Phone: 714-593-9630
  • Fax: 714-593-9632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number060000393
License Number StateCA

VIII. Authorized Official

Name: DR. CORDULA DICK-MUEHLKE
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 714-593-1840