Healthcare Provider Details

I. General information

NPI: 1518619014
Provider Name (Legal Business Name): HANDS ON HANDS CONGREGATE LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13880 PROCTOR AVE
LA PUENTE CA
91746-2529
US

IV. Provider business mailing address

4415 LA GRANADA WAY
LA CANADA FLINTRIDGE CA
91011-2908
US

V. Phone/Fax

Practice location:
  • Phone: 818-395-0517
  • Fax:
Mailing address:
  • Phone: 818-395-0517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: RHEA ORTIZ-LUIS
Title or Position: PRESIDENT
Credential:
Phone: 818-395-0517