PACIFIC ADHC INC. NPI 1124210497

NPI Information

NPI: 1124210497
Provider Name: PACIFIC ADHC INC.

Former Legal Business Name: DAYLIGHT SF VALLEY

Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

Address:
5562 RESEDA BLVD
TARZANA, CA
ZIP 91356
Phone: (818) 776-8700
Get Directions

PACIFIC ADHC INC. is an adult day care clinic center in Tarzana, CA. PACIFIC ADHC INC. NPI is 1124210497. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Daylight Sf Valley.

The provider's business location address is:

5562 RESEDA BLVD
TARZANA, CA
ZIP 91356
Phone: (818) 776-8700
Fax: (818) 776-8789

The provider's authorized official is Dong Jason Shin .
The authorized official title is Program Director and has the following contact phone number (818) 776-8700.

The CLIA number assigned to this NPI record is 05D1072810 - other - adult day health care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2007 and was last updated on 7/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care	060000692	CALIFORNIA	No
2	261QA0600X	Clinic/Center	Adult Day Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ADV70259G	MEDICAID	CALIFORNIA
2	0505035	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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