Healthcare Provider Details

I. General information

NPI: 1275445454
Provider Name (Legal Business Name): A PLACE LIKE HOME IX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13553 TAHOE ST
WESTMINSTER CA
92683-2555
US

IV. Provider business mailing address

13553 TAHOE ST
WESTMINSTER CA
92683-2555
US

V. Phone/Fax

Practice location:
  • Phone: 714-609-2303
  • Fax:
Mailing address:
  • Phone: 714-609-2303
  • 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: MARIA JASMIN AVILA
Title or Position: ADMINISTRATOR
Credential:
Phone: 714-609-2303