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General NPI Number Information
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NPI Number | 1043395742
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Entity Type | Organization
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Legal Business Name | THC - ORANGE COUNTY, LLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 550 N MONTEREY AVE
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City | ONTARIO
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State | CA
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Zip | 91764
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Country | US
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Telephone | 909-391-0333
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Fax | 909-391-2892
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Provider Business Mailing Address
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Address Line | 550 N MONTEREY AVE
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City | ONTARIO
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State | CA
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Zip | 91764-3318
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Country | US
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Telephone | 909-391-0333
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Fax | 909-391-2892
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHNETTA TRAYLOR
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Credential |
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Telephone | 502-596-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | 240000561
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License Number State | CA
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