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General NPI Number Information
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NPI Number | 1720876295
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Entity Type | Organization
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Legal Business Name | PRIME AGE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 8822 LIMONITE AVE
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City | JURUPA VALLEY
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State | CA
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Zip | 92509-5072
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Country | US
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Telephone | 626-686-7996
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Fax | 213-320-3566
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Provider Business Mailing Address
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Address Line | 8226 SPIRIT ST
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City | CHINO
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State | CA
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Zip | 91708-9454
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Country | US
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Telephone | 626-686-7996
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JIALING HUANG
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Credential |
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Telephone | 626-686-7996
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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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