Provider Demographics
NPI:1689302812
Name:EAST LOS ANGELES REMARKABLE CITZENS' ASSOCIATION, INC.
Entity Type:Organization
Organization Name:EAST LOS ANGELES REMARKABLE CITZENS' ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-718-7676
Mailing Address - Street 1:3839 SELIG PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-3143
Mailing Address - Country:US
Mailing Address - Phone:323-223-3079
Mailing Address - Fax:
Practice Address - Street 1:3839 SELIG PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-3143
Practice Address - Country:US
Practice Address - Phone:323-223-3079
Practice Address - Fax:323-223-4684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care