Healthcare Provider Details

I. General information

NPI: 1669660460
Provider Name (Legal Business Name): MACARTHUR ADHC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2007
Last Update Date: 10/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 S HOOVER ST
LOS ANGELES CA
90044-4911
US

IV. Provider business mailing address

8415 S HOOVER ST
LOS ANGELES CA
90044-4911
US

V. Phone/Fax

Practice location:
  • Phone: 323-750-5009
  • Fax: 323-750-5705
Mailing address:
  • Phone: 323-750-5009
  • Fax: 323-750-5705

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: ANTHONY DELONAY
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-750-5009