Organization Active NPI

Kheir Mirae Adult Day Health Care Center

  • Adult Day Care Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1396964110
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
060000909 Issued in CA
Legal business name
KHEIR MIRAE ADULT DAY HEALTH CARE CENTER
Practice address
717 S Western Ave.
Los Angeles, CA 90005-3113
Phone
(213) 427-4000
NPI assigned
Apr 24, 2007
Organization subpart
Yes
Parent organization
KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Authorized official

Name
Erin Pak
Title
Ceo - Adhc Administrator
Phone
(213) 427-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 060000909 CA Primary

Addresses

Primary practice location

717 S Western Ave.
Los Angeles, CA 90005-3113

Mailing address

3727 W 6TH St Ste 210
Los Angeles, CA 90020-5108

Other identifiers 1

IdentifierTypeStateIssuer
ADU70398FOtherCAPROVIDER NUMBER

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2249334Kheir Mirae Adult Day Health Care Center717 S Western Ave, Los Angeles, CA 90005Certificate of waiverJan 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Kheir Adult Day Health Care Center - Vermont7 organizations share this tax ID, including this one
Part of
Kheir Adult Day Health Care Center - Vermont

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14627 S Western Ave
Gardena, CA 90249
Phone (213) 804-7346

3727 W 6th St
Ste 210
Los Angeles, CA 90020
Phone (213) 235-2500

717 S Western Ave
Los Angeles, CA 90005
Phone (213) 427-4000

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1396964110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 W 6TH ST STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900205108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S WESTERN AVE.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053113",
            "telephone_number": "213-427-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHEIR MIRAE ADULT DAY HEALTH CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CEO - ADHC ADMINISTRATOR",
        "authorized_official_telephone_number": "213-427-4000"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "CA",
            "license": "060000909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "ADU70398F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.