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General NPI Number Information
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NPI Number | 1306659677
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Entity Type | Organization
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Legal Business Name | LUCKY ADULT DAY HEALTH CARE CENTER INC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 17661 COWAN
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City | IRVINE
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State | CA
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Zip | 92614-6031
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Country | US
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Telephone | 949-547-0202
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Fax | 818-349-2558
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Provider Business Mailing Address
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Address Line | 9420 RESEDA BLVD STE 3
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City | NORTHRIDGE
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State | CA
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Zip | 91324-6000
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Country | US
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Telephone | 949-547-0202
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Fax | 818-349-2558
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. QADEER AZAM
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Credential |
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Telephone | 949-547-0202
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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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