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General NPI Number Information
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NPI Number | 1518573526
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Entity Type | Organization
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Legal Business Name | A KA CENTER, LLC
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 4715 DIVINE WAY
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City | LA MESA
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State | CA
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Zip | 91941-6832
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Country | US
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Telephone | 858-349-3760
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8005
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City | RANCHO SANTA FE
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State | CA
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Zip | 92067-8005
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Country | US
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Telephone | 858-349-3760
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KIM HOANG
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Credential |
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Telephone | 858-349-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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