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General NPI Number Information
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NPI Number | 1053523142
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Entity Type | Organization
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Legal Business Name | FIVE ACES HEALTH CARE CORPORATION
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 18800 AMAR RD SUITE D-5
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City | WALNUT
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State | CA
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Zip | 91789-4166
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Country | US
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Telephone | 626-581-4034
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Fax | 626-581-1356
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Provider Business Mailing Address
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Address Line | 18800 AMAR RD SUITE D-5
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City | WALNUT
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State | CA
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Zip | 91789-4166
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Country | US
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Telephone | 626-581-4034
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Fax | 626-581-1356
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Authorized Official
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Title or Position | FISCAL OFFICER
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Name | MR. ALDRIN HALABASO FESTEJO
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Credential |
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Telephone | 626-581-4034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 060000731
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License Number State | CA
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