Organization
AGE WELL SENIOR SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARILYN L. DITTY (CHIEF EXECUTIVE OFFICER)
(949) 855-8033
Entity
Organization
Contact information
Practice address
24300 EL TORO RD, BLDG. A, SUITE 2000, LAGUNA WOODS, CA 92637-2737
(949) 855-8033
(949) 855-8025
Mailing address
24300 EL TORO RD, BLDG. A, SUITE 2000, LAGUNA WOODS, CA 92637-2737
(949) 855-8033
(949) 855-8025
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
CA161788
CA
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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