Provider Demographics
NPI:1669660460
Name:MACARTHUR ADHC INC
Entity Type:Organization
Organization Name:MACARTHUR ADHC INC
Other - Org Name:CITY OF REFUGE ADHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELONAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-750-5009
Mailing Address - Street 1:8415 S HOOVER ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-4911
Mailing Address - Country:US
Mailing Address - Phone:323-750-5009
Mailing Address - Fax:323-750-5705
Practice Address - Street 1:8415 S HOOVER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-4911
Practice Address - Country:US
Practice Address - Phone:323-750-5009
Practice Address - Fax:323-750-5705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-07
Last Update Date:2007-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70230FOtherMEDI-CAL PROVIDER NUMBER