Organization
MAGIC CIRCLE ADULT DAY HEALTH CARE CENTER INC.
Active
Other names
dba Prairie Place Adult Day Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAYE ANNETTE WILLIAMS PH.D. (CEO)
(310) 674-8345
Entity
Organization
Contact information
Practice address
105 S PRAIRIE AVE, INGLEWOOD, CA 90301-1969
(310) 674-8345
Mailing address
105 S PRAIRIE AVE, INGLEWOOD, CA 90301-1969
(310) 674-8345
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ADU70125F
—
CA
Enumeration date
06/07/2007
Last updated
08/14/2007
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