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General NPI Number Information
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NPI Number | 1104976612
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Entity Type | Organization
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Legal Business Name | FAMILY ADULT DAY HEALTHCARE
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2280 LOMITA BLVD
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City | LOMITA
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State | CA
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Zip | 90717-1436
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Country | US
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Telephone | 310-602-0123
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Fax | 310-602-0124
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Provider Business Mailing Address
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Address Line | 2280 LOMITA BLVD
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City | LOMITA
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State | CA
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Zip | 90717-1436
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Country | US
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Telephone | 310-602-0123
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Fax | 310-602-0124
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JOSEPHINE CHAVEZ
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Credential |
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Telephone | 310-602-0123
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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 |
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License Number State | CA
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