Provider Demographics
NPI:1245436930
Name:DELANO ADULT DAY HEALTH CARE CENTER
Entity type:Organization
Organization Name:DELANO ADULT DAY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELOISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:IGNACIO
Authorized Official - Suffix:
Authorized Official - Credentials:BUS ADMINISTRATION
Authorized Official - Phone:661-725-7070
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93216-0847
Mailing Address - Country:US
Mailing Address - Phone:661-725-7070
Mailing Address - Fax:661-725-9300
Practice Address - Street 1:1457 GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2034
Practice Address - Country:US
Practice Address - Phone:661-725-6115
Practice Address - Fax:661-725-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000617302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70291FMedicaid