Organization
FAIRMONT HEALTHCARE CORP.
Active
Other names
Casa Del Sol Adult Day Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY S DEVERA (CFO)
(626) 338-4606
Entity
Organization
Contact information
Practice address
13907 E. AMAR RD, UNIT D, LA PUENTE, CA 91746-1676
(626) 338-4606
Mailing address
13907 AMAR RD, UNIT D, LA PUENTE, CA 91746-1676
(626) 338-4606
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ADU70167G
PROVIDER NUMBER
CA
Enumeration date
12/15/2006
Last updated
08/22/2020
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