Healthcare Provider Details

I. General information

NPI: 1760800791
Provider Name (Legal Business Name): HOUSE OF SENIORS, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19950 VIA NATALIE
YORBA LINDA CA
92887-3149
US

IV. Provider business mailing address

19950 VIA NATALIE
YORBA LINDA CA
92887-3149
US

V. Phone/Fax

Practice location:
  • Phone: 714-458-0570
  • Fax: 714-917-2258
Mailing address:
  • Phone: 714-458-0570
  • Fax: 714-917-2258

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: MR. TERRY RECORDS
Title or Position: PARTNER
Credential:
Phone: 714-458-0570