Healthcare Provider Details

I. General information

NPI: 1396871885
Provider Name (Legal Business Name): YOUNG AGAIN DAY CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18220 SHERMAN WAY
RESEDA CA
91335-4550
US

IV. Provider business mailing address

18220 SHERMAN WAY
RESEDA CA
91335-4550
US

V. Phone/Fax

Practice location:
  • Phone: 818-758-0084
  • Fax: 818-758-0205
Mailing address:
  • Phone: 818-758-0084
  • Fax: 818-758-0205

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: DR. YONG T. LEE
Title or Position: FISCAL OFFICER
Credential: M.D
Phone: 818-758-0084