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General NPI Number Information
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NPI Number | 1184102287
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Entity Type | Organization
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Legal Business Name | KOREATOWN COMMUNITY BASED ADULT SERVICES, INC.
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 2140 W OLYMPIC BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90006-2250
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Country | US
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Telephone | 213-378-0101
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Fax | 213-378-0106
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Provider Business Mailing Address
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Address Line | 2140 W OLYMPIC BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90006-2250
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Country | US
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Telephone | 213-378-0101
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Fax | 213-378-0106
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TAEWOONG KIM
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Credential |
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Telephone | 213-378-0101
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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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