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General NPI Number Information
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NPI Number | 1033876081
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Entity Type | Organization
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Legal Business Name | CITRUS GARDENS LEASING LLC
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Dates
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Enumeration Date | 11/24/2021
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 25911 STANFORD ST
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City | HEMET
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State | CA
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Zip | 92544-4986
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Country | US
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Telephone | 951-925-7107
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Fax | 951-260-3869
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Provider Business Mailing Address
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Address Line | 3452 E FOOTHILL BLVD STE 720
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City | PASADENA
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State | CA
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Zip | 91107-6031
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Country | US
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Telephone | 626-796-8700
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Fax | 626-568-1416
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Authorized Official
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Title or Position | CO-OWNER, CO-MANAGER
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Name | TRACY LI LANGENDOEN
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Credential |
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Telephone | 626-796-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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