Provider Demographics
NPI:1396242459
Name:FRIENDSHIP ADULT DAY CARE CENTER, INC.
Entity type:Organization
Organization Name:FRIENDSHIP ADULT DAY CARE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-969-0859
Mailing Address - Street 1:89 EUCALYPTUS LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2901
Mailing Address - Country:US
Mailing Address - Phone:805-969-0859
Mailing Address - Fax:805-565-3828
Practice Address - Street 1:820 N FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-1823
Practice Address - Country:US
Practice Address - Phone:805-969-0859
Practice Address - Fax:805-565-3828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDSHIP ADULT DAY CARE CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425801731261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA425801731OtherCOMMUNITY CARE LICENSING