Organization
POWAY ADULT DAY HEALTH CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN FAYE HOLT B.A., M.A. (MANAGING MEMBER)
(858) 748-5044
Entity
Organization
Contact information
Practice address
13180 POWAY RD, POWAY, CA 92064-4612
(858) 748-5044
(858) 748-5405
Mailing address
10923 CAMINITO TIERRA, SAN DIEGO, CA 92131-3569
(858) 748-5044
(858) 748-5405
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ADU70301F
—
CA
Enumeration date
09/29/2007
Last updated
09/29/2007
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