Provider Demographics
NPI:1073163119
Name:GENTLE HEART DAYCARE CENTER
Entity Type:Organization
Organization Name:GENTLE HEART DAYCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NELLIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-592-5999
Mailing Address - Street 1:1275 E HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-5817
Mailing Address - Country:US
Mailing Address - Phone:626-592-5999
Mailing Address - Fax:
Practice Address - Street 1:1275 E HOLT AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-5817
Practice Address - Country:US
Practice Address - Phone:626-592-5999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care