Healthcare Provider Details

I. General information

NPI: 1720876295
Provider Name (Legal Business Name): PRIME AGE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8822 LIMONITE AVE
JURUPA VALLEY CA
92509-5072
US

IV. Provider business mailing address

8226 SPIRIT ST
CHINO CA
91708-9454
US

V. Phone/Fax

Practice location:
  • Phone: 626-686-7996
  • Fax: 213-320-3566
Mailing address:
  • Phone: 626-686-7996
  • Fax:

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: JIALING HUANG
Title or Position: MANAGER
Credential:
Phone: 626-686-7996