Healthcare Provider Details

I. General information

NPI: 1720696180
Provider Name (Legal Business Name): JEWEL HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20152 RIVERSIDE DR
NEWPORT BEACH CA
92660-1325
US

IV. Provider business mailing address

5111 HAMER LN
PLACENTIA CA
92870-3650
US

V. Phone/Fax

Practice location:
  • Phone: 714-340-6697
  • Fax:
Mailing address:
  • Phone: 714-340-6697
  • 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: JEHLA ROSE DELA ROSA
Title or Position: MANAGING MEMBER
Credential:
Phone: 949-394-8707