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General NPI Number Information
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NPI Number | 1053193326
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Entity Type | Organization
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Legal Business Name | BRENTWOOD, INC.
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1767 W BRENTWOOD PL
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City | ANAHEIM
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State | CA
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Zip | 92804-2508
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Country | US
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Telephone | 714-491-2840
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Fax | 714-778-3807
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Provider Business Mailing Address
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Address Line | 1767 W BRENTWOOD PL
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City | ANAHEIM
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State | CA
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Zip | 92804-2508
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Country | US
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Telephone | 714-491-2840
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Fax | 714-778-3807
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Authorized Official
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Title or Position | PRESIDENT/CFO
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Name | LOURDES ROGERS DECENZO
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Credential |
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Telephone | 714-296-1597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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