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General NPI Number Information
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NPI Number | 1891294328
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Entity Type | Organization
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Legal Business Name | VENUS SENIOR LLC
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Dates
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Enumeration Date | 02/10/2018
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Last Update Date | 02/10/2018
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Provider Practice Location Address
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Address Line | 35145 NEWARK BLVD
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City | NEWARK
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State | CA
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Zip | 94560-1219
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Country | US
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Telephone | 510-791-2492
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Fax | 510-494-1525
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Provider Business Mailing Address
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Address Line | 35145 NEWARK BLVD
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City | NEWARK
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State | CA
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Zip | 94560-1219
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Country | US
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Telephone | 510-791-2492
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Fax | 510-494-1525
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MISS MAYANK PATEL
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Credential |
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Telephone | 510-648-8254
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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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