JMK RESIDENTIAL FACILITY (NPI# 1578193801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578193801 |
| Entity Type | Organization |
| Organization Name | JMK RESIDENTIAL FACILITY |
| Practice Address |
1278 E 125th St Los Angeles CA 90059-3216 |
| Practice Telephone | 3107563839 |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2020-01-26 |
| Authorized Official Name | JEANETTE M KIDD (SECRETARY) |
| Authorized Official Telephone | 3107563839 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| Street Address |
1278 E 125TH ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059-3216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790314201 | Bright & Right Adult Day Health Care, Inc. | Clinic/Center | 261 S Kenmore Ave, Los Angeles, CA 90004-5604 | 2020-04-06 |
| 1679118475 | Heavenly Adhc, Inc. | Clinic/Center | 4777 Santa Monica Blvd, Los Angeles, CA 90029-2631 | 2019-11-15 |
| 1760026298 | Bliss Health Care Services, Inc. | Clinic/Center | 1501 W Washington Blvd, Los Angeles, CA 90007-1258 | 2019-10-28 |
| 1912555202 | Sun Bay Koreatown, LLC | Clinic/Center | 3060 W Olympic Blvd # 120, Los Angeles, CA 90006-3832 | 2019-08-29 |
| 1558921601 | Crenshaw Community Center LLC | Clinic/Center | 1060 Crenshaw Blvd, Los Angeles, CA 90019-1900 | 2019-06-19 |
| 1760042915 | Koreatown Senior Center LLC | Clinic/Center | 3400 W Olympic Blvd, Los Angeles, CA 90019-2122 | 2019-06-19 |
| 1306308499 | Lily Adult Day Health Care Center | Clinic/Center | 610 S Kingsley Dr, Los Angeles, CA 90005-2318 | 2019-04-05 |
| 1184102287 | Koreatown Community Based Services, Inc. | Clinic/Center | 2140 W Olympic Blvd Ste 100, Los Angeles, CA 90006-2250 | 2018-07-31 |
| 1962918334 | Brown and Pipkins Corporation | Clinic/Center | 10924 S Vermont Ave, Los Angeles, CA 90044-3016 | 2017-12-21 |
| 1851848659 | Academy of Nutrition and Dietetics | Clinic/Center | 4537 Don Tonito Dr, Los Angeles, CA 90008-4114 | 2016-09-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
Please comment or provide details below to improve the information on JMK RESIDENTIAL FACILITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.