Provider Demographics
NPI:1932294055
Name:MERIDIAN HEALTHCARE CORP.
Entity Type:Organization
Organization Name:MERIDIAN HEALTHCARE CORP.
Other - Org Name:CYPRESS ADULT DAY HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATIVIDAD
Authorized Official - Middle Name:L
Authorized Official - Last Name:RILLORTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-826-9664
Mailing Address - Street 1:4470 LINCOLN AVENUE
Mailing Address - Street 2:UNITS 1,2,3
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-6110
Mailing Address - Country:US
Mailing Address - Phone:714-826-9664
Mailing Address - Fax:714-826-9614
Practice Address - Street 1:4470 LINCOLN AVENUE
Practice Address - Street 2:UNITS 1,2,3
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-6110
Practice Address - Country:US
Practice Address - Phone:714-826-9664
Practice Address - Fax:714-826-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
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
CAADU70183GOtherMEDI-CAL PROVIDER NUMBER