Healthcare Provider Details

I. General information

NPI: 1174394753
Provider Name (Legal Business Name): MORNING SUNRISE VILLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9061 ORANGEWOOD AVE
GARDEN GROVE CA
92841-2068
US

IV. Provider business mailing address

9061 ORANGEWOOD AVE
GARDEN GROVE CA
92841-2068
US

V. Phone/Fax

Practice location:
  • Phone: 213-407-4912
  • Fax:
Mailing address:
  • Phone: 213-407-4912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHEILA MARIE STONEHOCKER
Title or Position: LVN
Credential:
Phone: 818-807-0468