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General NPI Number Information
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NPI Number | 1770039844
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Entity Type | Organization
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Legal Business Name | D4, INC.
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 4541 N FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90065-3026
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Country | US
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Telephone | 323-221-1221
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Fax | 323-223-7463
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Provider Business Mailing Address
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Address Line | 4541 N FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90065-3026
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Country | US
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Telephone | 323-221-1221
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Fax | 323-223-7463
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Authorized Official
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Title or Position | MANAGER
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Name | MS. VICKI P. ROLLINS
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Credential | RN
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Telephone | 323-223-1221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 198600915
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License Number State | CA
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