Provider Demographics
NPI:1720876295
Name:PRIME AGE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:PRIME AGE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JIALING
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-686-7996
Mailing Address - Street 1:8226 SPIRIT ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91708-9454
Mailing Address - Country:US
Mailing Address - Phone:626-686-7996
Mailing Address - Fax:
Practice Address - Street 1:8822 LIMONITE AVE
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92509-5072
Practice Address - Country:US
Practice Address - Phone:626-686-7996
Practice Address - Fax:213-320-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care