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General NPI Number Information
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NPI Number | 1285467654
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Entity Type | Organization
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Legal Business Name | YOUR TRAVEL COORDINATORS LLC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 5520 EILEEN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90043-2256
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Country | US
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Telephone | 323-792-4156
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Fax | 877-427-4238
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Provider Business Mailing Address
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Address Line | 335 E ALBERTONI ST STE 200-609
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City | CARSON
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State | CA
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Zip | 90746-1425
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Country | US
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Telephone | 562-489-4279
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Fax |
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Authorized Official
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Title or Position | OWNER/ ARF ADMINISTRATOR
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Name | MS. RICKA THOMAS
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Credential |
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Telephone | 562-489-4279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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