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NPI Code Detail

MEDICARE: GOODLIFE ADULT DAY HEALTH CARE CENTER

MEDICARE: GOODLIFE ADULT DAY HEALTH CARE CENTER
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
1261QA0600XAdult Day Care Clinic/Center0600885CA

General Provider Information

NPI Number : 1992924856
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOODLIFE ADULT DAY HEALTH CARE CENTER
Provider Business Mailing Address
First Line : 1617 BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90026-5710
Country : US
Telephone Number : 213-250-9191
Fax Number : 213-250-9595
Provider Business Practice Location Address
First Line : 1617 BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90026-5710
Country : US
Telephone Number : 213-250-9191
Fax Number : 213-250-9595
Authorized Official
Title or Position : CEO
Name : MR. BEHKAM NIKAEIN
Credential :
Telephone Number : 213-250-9191
Provider Enumeration Date : 04/25/2007
Last Update Date : 12/18/2007

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Directions to “GOODLIFE ADULT DAY HEALTH CARE CENTER ” Practice Location

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