Provider Demographics
NPI:1891853602
Name:JUBILEE ADULT DAY HEALTH CARE CENTER
Entity Type:Organization
Organization Name:JUBILEE ADULT DAY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARCELI
Authorized Official - Middle Name:NAVAL
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-668-7400
Mailing Address - Street 1:3155 GLENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1805
Mailing Address - Country:US
Mailing Address - Phone:323-668-7400
Mailing Address - Fax:323-668-7402
Practice Address - Street 1:3155 GLENDALE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1805
Practice Address - Country:US
Practice Address - Phone:323-668-7400
Practice Address - Fax:323-668-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70337FMedicaid