Provider Demographics
NPI:1851466213
Name:HEALTHY LIVING ADULT DAY HEALTH CARE
Entity Type:Organization
Organization Name:HEALTHY LIVING ADULT DAY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAHROOZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMEKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-321-1580
Mailing Address - Street 1:4410 N PECK ROAD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732
Mailing Address - Country:US
Mailing Address - Phone:626-450-0700
Mailing Address - Fax:626-454-1806
Practice Address - Street 1:4410 N PECK ROAD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732
Practice Address - Country:US
Practice Address - Phone:626-450-0700
Practice Address - Fax:626-454-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70340FMedicaid