Provider Demographics
NPI:1790393718
Name:ANGELES DEL SOL ADHC, LLC
Entity Type:Organization
Organization Name:ANGELES DEL SOL ADHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BOYU
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-322-2777
Mailing Address - Street 1:820 N DIAMOND BAR BLVD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1039
Mailing Address - Country:US
Mailing Address - Phone:626-322-2777
Mailing Address - Fax:626-788-1352
Practice Address - Street 1:820 N DIAMOND BAR BLVD
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1039
Practice Address - Country:US
Practice Address - Phone:626-322-2777
Practice Address - Fax:626-788-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care