Healthcare Provider Details

I. General information

NPI: 1770669327
Provider Name (Legal Business Name): ROSE-LUANN HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17231 REGULUS DR.
YORBA LINDA CA
92886
US

IV. Provider business mailing address

17231 REGULUS DR.
YORBA LINDA CA
92886
US

V. Phone/Fax

Practice location:
  • Phone: 714-528-6187
  • Fax: 714-996-9211
Mailing address:
  • Phone: 714-528-6187
  • Fax: 714-996-9211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number060000806
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSALINDA C. ULIT
Title or Position: PRESIDENT
Credential:
Phone: 714-496-9990