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General NPI Number Information
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NPI Number | 1457497885
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Entity Type | Organization
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Legal Business Name | INLAND EMPIRE ADULT DAY HEALTHCARE CENTER, INC.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 135 N MCKINLEY ST
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City | CORONA
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State | CA
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Zip | 92879-6566
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Country | US
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Telephone | 951-808-9600
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Fax | 951-808-9178
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Provider Business Mailing Address
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Address Line | 135 N MCKINLEY ST
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City | CORONA
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State | CA
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Zip | 92879-6566
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Country | US
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Telephone | 951-808-9600
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Fax | 951-808-9178
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LILLIANA CASTRO
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Credential | DDS
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Telephone | 951-808-9600
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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 | 060000870
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License Number State | CA
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