Poway Adult Day Health Care Center LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

POWAY ADULT DAY HEALTH CARE CENTER LLC

Practice address

13180 Poway Rd
Poway, CA 92064-4612

Phone

(858) 748-5044

Fax

(858) 748-5405

NPI assigned

Sep 29, 2007

Last updated

Sep 29, 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

Mrs. Kathryn Faye Holt, B.A., M.A.

Title

Managing Member

Phone

(858) 748-5044

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191024000000",
    "number": "1568659977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10923 CAMINITO TIERRA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313569",
            "telephone_number": "858-748-5044",
            "fax_number": "858-748-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13180 POWAY RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644612",
            "telephone_number": "858-748-5044",
            "fax_number": "858-748-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWAY ADULT DAY HEALTH CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-29",
        "last_updated": "2007-09-29",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "858-748-5044",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.A., M.A."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ADU70301F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Poway, CA
• Providers in Poway, CA by specialty
• Adult Day Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.