Magic Circle Adult Day Health Care Center Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

MAGIC CIRCLE ADULT DAY HEALTH CARE CENTER INC.

Doing business as

dba Prairie Place Adult Day Health Care Center

Practice address

105 S Prairie Ave
Inglewood, CA 90301-1969

Phone

(310) 674-8345

NPI assigned

Jun 7, 2007

Last updated

Aug 14, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Faye Annette Williams, PH.D.

Title

Ceo

Phone

(310) 674-8345

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• dba Prairie Place Adult Day Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1326241332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011969",
            "telephone_number": "310-674-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011969",
            "telephone_number": "310-674-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC CIRCLE ADULT DAY HEALTH CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FAYE",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-674-8345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ADU70125F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Prairie Place Adult Day Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genessis Yazmin Macias
• Sara Yusko Madden, NP-C
• Made New Foundation Inc
• Sandra K Maeshiro
• Rebecca Maghen, MD
• Lillian Maglaris Gabaldon
• Paul Kalani Makanui, PH. D.
• Kinsey Nabiha Nadia Makkar
• Laura Malandrino, APCC
• Charity Maldonado

• Developmentally Disabled Services Day Training Agency in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Developmentally Disabled Services Day Training Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.