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General NPI Number Information
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NPI Number | 1558902767
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Entity Type | Organization
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Legal Business Name | HEALTH ALLIANCE ADHC, INC
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 3240 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-1308
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Country | US
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Telephone | 800-420-2356
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Fax | 800-420-0481
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Provider Business Mailing Address
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Address Line | 1245 W CIENEGA AVE SPC 106
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City | SAN DIMAS
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State | CA
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Zip | 91773-2826
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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 | PRESIDENT
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Name | JOSE E DE CASTRO
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Credential |
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Telephone | 626-216-8999
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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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