Healthcare Provider Details

I. General information

NPI: 1063634046
Provider Name (Legal Business Name): GOOD TIME ADULT DAY HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1961 E FLORENCE AVE
LOS ANGELES CA
90001-2700
US

IV. Provider business mailing address

1961 E FLORENCE AVE
LOS ANGELES CA
90001-2700
US

V. Phone/Fax

Practice location:
  • Phone: 323-587-9895
  • Fax: 323-587-9533
Mailing address:
  • Phone: 323-587-9895
  • Fax: 323-587-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARINE MARGARIAN
Title or Position: PRESIDENT
Credential:
Phone: 323-587-9895