Healthcare Provider Details

I. General information

NPI: 1093474306
Provider Name (Legal Business Name): BTC SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16803 MAPLE ST
FOUNTAIN VALLEY CA
92708-2226
US

IV. Provider business mailing address

9049 LEMONGRASS CT
FOUNTAIN VALLEY CA
92708-5604
US

V. Phone/Fax

Practice location:
  • Phone: 714-785-9555
  • Fax:
Mailing address:
  • Phone: 714-785-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TIN LE
Title or Position: CFO
Credential:
Phone: 714-600-7083