Healthcare Provider Details

I. General information

NPI: 1013840552
Provider Name (Legal Business Name): LAKE ELSINORE CONGREGATE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33450 WALHAM PL
LAKE ELSINORE CA
92530-5612
US

IV. Provider business mailing address

6333 PLUM AVE
EASTVALE CA
92880-8913
US

V. Phone/Fax

Practice location:
  • Phone: 626-277-9032
  • Fax:
Mailing address:
  • Phone: 626-277-9032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. JACLYN ELAINE ARGAO ROJAS
Title or Position: DIRECTOR OF NURSING
Credential: NP
Phone: 626-277-9032