Provider Demographics
NPI:1891915567
Name:ONEGENERATION
Entity Type:Organization
Organization Name:ONEGENERATION
Other - Org Name:ONEGENERATION ADULT DAY HEALTHCARE PROGR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-708-6373
Mailing Address - Street 1:17400 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5349
Mailing Address - Country:US
Mailing Address - Phone:718-708-6625
Mailing Address - Fax:818-996-2960
Practice Address - Street 1:17400 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-5349
Practice Address - Country:US
Practice Address - Phone:718-708-6625
Practice Address - Fax:818-996-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70104FMedicare ID - Type UnspecifiedPROVIDER