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General NPI Number Information
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NPI Number | 1497969638
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Entity Type | Organization
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Legal Business Name | EAST VALLEY ADULT DAY HEALTH CARE CENTER,INC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 8612 VAN NUYS BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-2913
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Country | US
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Telephone | 818-951-8608
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Fax | 818-951-9547
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Provider Business Mailing Address
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Address Line | 8612 VAN NUYS BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-2913
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Country | US
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Telephone | 818-951-8608
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Fax | 818-945-9547
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JUDITH CANTERBURY
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Credential |
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Telephone | 818-951-8608
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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 | ADU70198F
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License Number State | CA
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