Organization
BEVERLY ADULT DAY HEALTH CARE CENTER, INC.
Active
Other names
Beverly Adult Day Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IN JA LEE (OWNER)
(323) 957-9777
Entity
Organization
Contact information
Practice address
316 N WESTERN AVE, LOS ANGELES, CA 90004-2615
(323) 957-9777
(323) 957-9741
Mailing address
316 N WESTERN AVE, LOS ANGELES, CA 90004-2615
(323) 957-9777
(323) 957-9741
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
060000905
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ADU70391F
MEDI-CAL PROVIDER NUMBER
CA
01
—
CMCSUBKUZ
CMC UPLOAD NUMBER
CA
Enumeration date
05/30/2007
Last updated
02/28/2023
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