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General NPI Number Information
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NPI Number | 1992993661
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Entity Type | Organization
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Legal Business Name | CARSON ADULT DAY HEALTH CARE CENTER,INC.
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 451 E CARSON PLAZA DR SUITE 105
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City | CARSON
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State | CA
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Zip | 90746-3247
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Country | US
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Telephone | 310-354-0031
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Fax | 310-354-3939
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Provider Business Mailing Address
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Address Line | PO BOX 11067
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City | CARSON
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State | CA
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Zip | 90749-1067
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Country | US
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Telephone | 310-354-0031
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Fax | 310-354-3939
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. EMMA FAJARDO CASTANEDA
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Credential | R.N
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Telephone | 310-354-0078
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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 | CA
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