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General NPI Number Information
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NPI Number | 1396964110
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Entity Type | Organization
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Legal Business Name | KHEIR MIRAE ADULT DAY HEALTH CARE CENTER
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 717 S WESTERN AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90005-3113
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Country | US
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Telephone | 213-427-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3727 W 6TH ST STE 210
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City | LOS ANGELES
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State | CA
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Zip | 90020-5108
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO - ADHC ADMINISTRATOR
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Name | ERIN PAK
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Credential |
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Telephone | 213-427-4000
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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 | 060000909
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License Number State | CA
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