1194807297 NPI number — AIDS FOR DAILY LIVING, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194807297 NPI number — AIDS FOR DAILY LIVING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIDS FOR DAILY LIVING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADL, INC.
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194807297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1140 SUNSET BLVD
Provider Second Line Business Mailing Address:
SUITE #140
Provider Business Mailing Address City Name:
ROCKLIN
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95765-3770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-624-0900
Provider Business Mailing Address Fax Number:
916-624-9801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1140 SUNSET BLVD
Provider Second Line Business Practice Location Address:
SUITE #140
Provider Business Practice Location Address City Name:
ROCKLIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95765-3770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-624-0900
Provider Business Practice Location Address Fax Number:
916-624-9801
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PEREIRA
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
916-624-0900

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DME02293F . This is a "MEDICAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DMR00030R . This is a "BLUE SHIELD OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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