Healthcare Provider Details

I. General information

NPI: 1881466449
Provider Name (Legal Business Name): SALIDA DEL SOL ADHC, LLC DBA ORANGE DEL SOL ADHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14511 FRANKLIN AVE STE 100
TUSTIN CA
92780-7213
US

IV. Provider business mailing address

14511 FRANKLIN AVE STE 100
TUSTIN CA
92780-7213
US

V. Phone/Fax

Practice location:
  • Phone: 949-561-0999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BOYU LIU
Title or Position: MANAGER
Credential:
Phone: 949-561-0999