BEVERLY ADULT DAY HEALTH CARE CENTER INC. NPI 1306047097

NPI Information

NPI: 1306047097
Provider Name: BEVERLY ADULT DAY HEALTH CARE CENTER, INC.

Doing Business As: BEVERLY ADULT DAY HEALTH CARE CENTER

Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 05D1020648

Address:
316 N WESTERN AVE
LOS ANGELES, CA
ZIP 90004
Phone: (323) 957-9777
Get Directions

BEVERLY ADULT DAY HEALTH CARE CENTER, INC. is an adult day care clinic center in Los Angeles, CA. BEVERLY ADULT DAY HEALTH CARE CENTER, INC. NPI is 1306047097. The provider is registered as an organization entity type.
The provider Is Doing Business As Beverly Adult Day Health Care Center.

The provider's business location address is:

316 N WESTERN AVE
LOS ANGELES, CA
ZIP 90004-615
Phone: (323) 957-9777
Fax: (323) 957-9741

The provider's authorized official is In Ja Lee .
The authorized official title is Owner and has the following contact phone number (323) 957-9777.

The CLIA number assigned to this NPI record is 05D1020648 - other - adult day health care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/30/2007 and was last updated on 2/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care	060000905	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ADU70391F	OTHER	CALIFORNIA	MEDI-CAL PROVIDER NUMBER
2	CMCSUBKUZ	OTHER	CALIFORNIA	CMC UPLOAD NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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