Individual provider · NPI-1

Rayjennia Adams

Assisted Living Facility · Los Angeles, CA

NPI number1902654932
StatusActive
Last updated in NPPESMay 6, 2024

Details

NPI
1902654932
Entity type
Individual (NPI-1)
Name
Rayjennia Adams
Sex
Female
Sole proprietor
Yes
Enumeration date
May 6, 2024
Certification date
May 6, 2024
Last updated
May 6, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility198320408CAYes

Practice location

430 W 109th Pl
Los Angeles, CA 90061-1514

Phone 323-574-3841

Mailing address

430 W 109th Pl
Los Angeles, CA 90061-1514

Phone 323-574-3841

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