Healthcare Provider Details

I. General information

NPI: 1679347165
Provider Name (Legal Business Name): LIHA ADULT DAY HEALTH CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10086 MILLS STATION RD
SACRAMENTO CA
95827-2204
US

IV. Provider business mailing address

10086 MILLS STATION RD
SACRAMENTO CA
95827-2204
US

V. Phone/Fax

Practice location:
  • Phone: 279-688-0006
  • Fax: 279-688-0009
Mailing address:
  • Phone: 279-688-0006
  • Fax: 279-688-0009

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: ROMELA GRIGORYAN
Title or Position: OWNER
Credential: RN
Phone: 323-800-4040