Organization
PREMIERONE PLUS CBAS
Active
Other names
Gaon Adult Day Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH PARK (MANAGER)
(714) 495-4392
Entity
Organization
Contact information
Practice address
1035 N MAGNOLIA AVE, ANAHEIM, CA 92801-3116
(714) 495-4392
(714) 388-3354
Mailing address
6800 LINCOLN AVE STE 200, BUENA PARK, CA 90620-4164
(144) 954-3927
(714) 388-3354
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
04/18/2025
Last updated
07/14/2025
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