Healthcare Provider Details

I. General information

NPI: 1144145905
Provider Name (Legal Business Name): UP N OUT SOCIAL CLUB OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16171 CAIRO CIR
PLACENTIA CA
92870-3001
US

IV. Provider business mailing address

4931 CARTHAGE ST
PLACENTIA CA
92870-3004
US

V. Phone/Fax

Practice location:
  • Phone: 949-394-8708
  • Fax:
Mailing address:
  • Phone: 949-394-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MARIAN MEJIA ALVAREZ
Title or Position: PRESIDENT
Credential:
Phone: 949-394-8708