Healthcare Provider Details

I. General information

NPI: 1952226672
Provider Name (Legal Business Name): TABITHA CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14412 COKE AVE
PARAMOUNT CA
90723-3612
US

IV. Provider business mailing address

14412 COKE AVE
PARAMOUNT CA
90723-3612
US

V. Phone/Fax

Practice location:
  • Phone: 562-788-7639
  • Fax:
Mailing address:
  • Phone: 562-788-7639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: TABITHA ADELEKE
Title or Position: LICENSEE
Credential:
Phone: 562-788-7639