1760059364 NPI number — PARTNERSHIP ADULT HOME CARE LLC

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 1760059364 NPI number — PARTNERSHIP ADULT HOME CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARTNERSHIP ADULT HOME CARE LLC
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:
Provider Other Organization Name Type Code:
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:
1760059364
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15424 HAWTHORNE BLVD, P.O BOX 603
Provider Second Line Business Mailing Address:
SUITE 203C
Provider Business Mailing Address City Name:
LAWNDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
424-456-4550
Provider Business Mailing Address Fax Number:
424-456-4824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15424 HAWTHORNE BLVD STE 203C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWNDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90260-2153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-456-4550
Provider Business Practice Location Address Fax Number:
424-456-4824
Provider Enumeration Date:
06/10/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ANYIM
Authorized Official First Name:
THERESA
Authorized Official Middle Name:
CHINWE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
424-456-4550

Provider Taxonomy Codes

  • Taxonomy code: 3747A0650X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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