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General NPI Number Information
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NPI Number | 1003374059
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE HOME CONGREGATE FACILITY LLC
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 1457 S NUTWOOD ST
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City | ANAHEIM
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State | CA
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Zip | 92804-6067
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Country | US
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Telephone | 800-811-3151
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Fax | 800-811-5942
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Provider Business Mailing Address
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Address Line | 1457 S NUTWOOD ST
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City | ANAHEIM
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State | CA
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Zip | 92804-6067
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Country | US
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Telephone | 800-811-3151
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Fax | 800-811-5942
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR OF NURSING
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Name | MR. LAMBERTO VALIENTE JR.
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Credential | RN
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Telephone | 800-811-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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