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General NPI Number Information
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NPI Number | 1285859249
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Entity Type | Organization
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Legal Business Name | KINGSLEY PLACE ADULT HEALTH DAY CARE INC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 548 S KINGSLEY DR
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City | LOS ANGELES
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State | CA
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Zip | 90020-3506
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Country | US
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Telephone | 213-383-3303
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Fax | 213-384-1772
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Provider Business Mailing Address
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Address Line | 548 S KINGSLEY DR
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City | LOS ANGELES
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State | CA
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Zip | 90020-3506
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Country | US
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Telephone | 213-383-3303
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Fax | 213-384-1772
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Authorized Official
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Title or Position | CEO
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Name | CRYSTAL PAK
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Credential |
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Telephone | 213-383-3303
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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 | 060000786
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License Number State | CA
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