Healthcare Provider Details

I. General information

NPI: 1144108697
Provider Name (Legal Business Name): GRANT ADULT DAY PROGRAMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 1/2 S SEPULVEDA BLVD
LOS ANGELES CA
90049-3116
US

IV. Provider business mailing address

152 1/2 S SEPULVEDA BLVD
LOS ANGELES CA
90049-3116
US

V. Phone/Fax

Practice location:
  • Phone: 310-709-9108
  • Fax:
Mailing address:
  • Phone: 310-709-9108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: NADIIA GRANT
Title or Position: CEO
Credential: MS
Phone: 424-446-0737