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General NPI Number Information
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NPI Number | 1255850814
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Entity Type | Organization
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Legal Business Name | MAGNOLIA ADULT DAY HEALTH CARE, INC.
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Dates
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Enumeration Date | 09/14/2017
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 206 W 15TH ST
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City | SANTA ANA
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State | CA
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Zip | 92701-2307
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Country | US
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Telephone | 657-210-2379
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Fax |
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Provider Business Mailing Address
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Address Line | 202 HOSPITAL CIR
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City | WESTMINSTER
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State | CA
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Zip | 92683-3910
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Country | US
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Telephone | 714-894-5880
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | GINA TRUONG
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Credential |
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Telephone | 714-894-5880
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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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