Healthcare Provider Details

I. General information

NPI: 1255824389
Provider Name (Legal Business Name): VALLEY ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E OAK AVE
PORTERVILLE CA
93257-3932
US

IV. Provider business mailing address

227 E OAK AVE
PORTERVILLE CA
93257-3932
US

V. Phone/Fax

Practice location:
  • Phone: 559-783-9815
  • Fax:
Mailing address:
  • Phone: 559-783-9815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number547200750
License Number StateCA

VIII. Authorized Official

Name: KAYLA F. MULLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 559-783-9815