Provider Demographics
NPI:1063602985
Name:JFS PARTNERS ADULT DAY HEALTH CARE CENTER
Entity type:Organization
Organization Name:JFS PARTNERS ADULT DAY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF LONG TERM CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LODGEN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-769-0560
Mailing Address - Street 1:7362 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6619
Mailing Address - Country:US
Mailing Address - Phone:323-883-0330
Mailing Address - Fax:323-883-0344
Practice Address - Street 1:7362 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6619
Practice Address - Country:US
Practice Address - Phone:323-883-0330
Practice Address - Fax:323-883-0344
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEWISH FAMILY SERVICE OF LOS ANGELES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70074GMedicaid