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General NPI Number Information
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NPI Number | 1134767767
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Entity Type | Organization
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Legal Business Name | WISDOM ADULT DAY PARTNERS, LLC.
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 2255 S DEPOT ST
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City | SANTA MARIA
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State | CA
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Zip | 93455-1216
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Country | US
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Telephone | 805-917-2005
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Fax |
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Provider Business Mailing Address
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Address Line | 2955 E HILLCREST DR STE 129
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3178
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Country | US
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Telephone | 805-917-2005
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMANDA SILLARS
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Credential |
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Telephone | 805-917-2005
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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 |
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