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General NPI Number Information
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NPI Number | 1326116393
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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 | 11/30/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 14501 MAGNOLIA ST STE 107
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City | WESTMINSTER
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State | CA
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Zip | 92683-5542
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Country | US
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Telephone | 714-894-5880
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Fax | 714-894-5879
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Provider Business Mailing Address
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Address Line | 14501 MAGNOLIA ST STE 107
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City | WESTMINSTER
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State | CA
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Zip | 92683-5542
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Country | US
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Telephone | 714-894-5880
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Fax | 714-894-5879
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. GINA TRUONG
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Credential | J.D.
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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 | 0600890
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License Number State | CA
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