MEDICARE: VIOLET RESIDENTIAL CARE 2, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1073318119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIOLET RESIDENTIAL CARE 2, INC.

Provider Business Mailing Address
First Line	:	2015 W SAINT ANNE PL
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-4621
Country	:	US
Telephone Number	:	310-972-0128
Fax Number	:	714-583-8560

Provider Business Practice Location Address
First Line	:	2015 W SAINT ANNE PL
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-4621
Country	:	US
Telephone Number	:	310-972-0128
Fax Number	:	714-583-8560

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MRS. VIOLETA AMURAO
Credential	:
Telephone Number	:	310-972-0128

Provider Enumeration Date	:	02/13/2025
Last Update Date	:	02/13/2025

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