Provider Demographics
NPI:1588878516
Name:SHERMAN WAY ADULT DAY HEALTH CARE CENTER, INC.
Entity type:Organization
Organization Name:SHERMAN WAY ADULT DAY HEALTH CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:JOON
Authorized Official - Last Name:PYUN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, PHD (ABD)
Authorized Official - Phone:818-654-0123
Mailing Address - Street 1:18301 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4425
Mailing Address - Country:US
Mailing Address - Phone:818-654-0123
Mailing Address - Fax:818-654-0121
Practice Address - Street 1:18301 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4425
Practice Address - Country:US
Practice Address - Phone:818-654-0123
Practice Address - Fax:818-654-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare