Healthcare Provider Details

I. General information

NPI: 1841746617
Provider Name (Legal Business Name): LAO FAMILY COMMUNITY EMPOWERMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8338 WEST LN STE 105
STOCKTON CA
95210-3145
US

IV. Provider business mailing address

8338 WEST LN STE 105
STOCKTON CA
95210-3145
US

V. Phone/Fax

Practice location:
  • Phone: 209-466-0721
  • Fax: 209-466-6567
Mailing address:
  • Phone: 209-466-0721
  • Fax: 209-466-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GER VANG
Title or Position: CEO
Credential:
Phone: 209-466-0721