Healthcare Provider Details

I. General information

NPI: 1235799339
Provider Name (Legal Business Name): FRENCH VALLEY ADHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11256 CANDLEBERRY CT
SAN DIEGO CA
92128-3612
US

IV. Provider business mailing address

11256 CANDLEBERRY CT
SAN DIEGO CA
92128-3612
US

V. Phone/Fax

Practice location:
  • Phone: 619-573-0718
  • Fax:
Mailing address:
  • Phone: 619-573-0718
  • Fax:

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: MISS ABIGAIL PEROS
Title or Position: ADMINISTRATOR
Credential:
Phone: 619-573-0718