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General NPI Number Information
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NPI Number | 1326707092
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Entity Type | Organization
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Legal Business Name | MANNA HEALTHCARE INC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 10144 CENTRAL AVE
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City | MONTCLAIR
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State | CA
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Zip | 91763-3851
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Country | US
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Telephone | 909-364-1974
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Fax |
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Provider Business Mailing Address
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Address Line | 16675 SLATE DR UNIT 634
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City | CHINO HILLS
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State | CA
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Zip | 91709-7415
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Country | US
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Telephone | 714-757-3079
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WI YOUNG LEE
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Credential |
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Telephone | 714-757-3079
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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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