MEDICARE: ALMA FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CX104B	OTHER	CA	MEDICARE PROVIDER TRANSATION ACCESS NUMBER (PTAN)

General Provider Information

NPI Number	:	1700249893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALMA FAMILY SERVICES

Provider Business Mailing Address
First Line	:	900 CORPORATE CENTER DR STE 350
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7620
Country	:	US
Telephone Number	:	323-526-4016
Fax Number	:	323-526-4096

Provider Business Practice Location Address
First Line	:	2958 E FLORENCE AVE FL 2
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5826
Country	:	US
Telephone Number	:	323-923-9559
Fax Number	:	323-923-9566

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MARIA DE LOURDES CARACOZA
Credential	:
Telephone Number	:	323-526-4016

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	04/11/2022

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