Healthcare Provider Details

I. General information

NPI: 1932015567
Provider Name (Legal Business Name): NOVACARE HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5122 W ROBERTS DR
SANTA ANA CA
92704-1956
US

IV. Provider business mailing address

5122 W ROBERTS DR
SANTA ANA CA
92704-1956
US

V. Phone/Fax

Practice location:
  • Phone: 657-397-7157
  • Fax:
Mailing address:
  • Phone: 657-397-7157
  • 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: RICKY VU
Title or Position: RCFE ADMINISTRATOR
Credential: OWNER
Phone: 714-880-9100