Organization
ACACIA ADULT DAY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MALLORY VEGA (EXECUTIVE DIRECTOR)
(714) 530-1566
Entity
Organization
Contact information
Practice address
11391 ACACIA PKWY, GARDEN GROVE, CA 92840-5310
(714) 530-1566
(714) 530-1592
Mailing address
11391 ACACIA PKWY, GARDEN GROVE, CA 92840-5310
(714) 530-1566
(714) 530-1592
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
060000363
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ADU70087F
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
08/23/2005
Last updated
03/17/2017
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