Provider Demographics
NPI:1215140397
Name:EAST LOS ANGELES REMARKABLE CITZENS' ASSOCIATION, INC.
Entity type:Organization
Organization Name:EAST LOS ANGELES REMARKABLE CITZENS' ASSOCIATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-223-3079
Mailing Address - Street 1:3839 SELIG PL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-3143
Mailing Address - Country:US
Mailing Address - Phone:323-223-3079
Mailing Address - Fax:323-223-4684
Practice Address - Street 1:4008 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-3404
Practice Address - Country:US
Practice Address - Phone:323-895-7896
Practice Address - Fax:323-895-7897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000591261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care