Healthcare Provider Details

I. General information

NPI: 1154374619
Provider Name (Legal Business Name): AUREUS ACQUISITION III, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31741 RANCHO VIEJO RD
SAN JUAN CAPISTRANO CA
92675-6722
US

IV. Provider business mailing address

7900 WESTPARK DR T-900, ATT: MEDICARE BILLING, M. GARCIA
MC LEAN VA
22102-4242
US

V. Phone/Fax

Practice location:
  • Phone: 949-248-8855
  • Fax: 949-848-8319
Mailing address:
  • Phone: 703-854-0823
  • Fax: 703-854-0164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number060000526
License Number StateCA

VIII. Authorized Official

Name: ROBER HENDERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 949-248-8855