=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013099381
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAJAY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24888 HEIL DR
-----------------------------------------------------
City | MORENO VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92553-5879
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-247-9818
-----------------------------------------------------
Fax | 951-243-6782
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24909 NOGAL ST
-----------------------------------------------------
City | MORENO VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92553-5830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-247-9818
-----------------------------------------------------
Fax | 951-243-6782
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. NAOMI BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 951-247-9818
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315P00000X
-----------------------------------------------------
Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------