Healthcare Provider Details

I. General information

NPI: 1861868721
Provider Name (Legal Business Name): ALHL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 S HAM LN
LODI CA
95242-3903
US

IV. Provider business mailing address

1334 S HAM LN
LODI CA
95242-3903
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-3825
  • Fax: 209-224-5262
Mailing address:
  • Phone: 209-334-3825
  • Fax: 209-224-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number030000138
License Number StateCA

VIII. Authorized Official

Name: MR. COLTON RAWE
Title or Position: MANAGER
Credential:
Phone: 949-347-7100