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NPI 1194688069

NPI 1194688069 : ANTONY CARE HOMES 1 LLC : FOUNTAIN VALLEY, CA

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General NPI Number Information
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    NPI Number           |    1194688069
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANTONY CARE HOMES 1 LLC 
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Dates
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    Enumeration Date     |    12/06/2025
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    Last Update Date     |    12/06/2025
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Provider Practice Location Address
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    Address Line         |    9433 GERANIUM CIR 
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    City                 |    FOUNTAIN VALLEY
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    State                |    CA
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    Zip                  |    92708-1920
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    Country              |    US
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    Telephone            |    714-883-3017
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9433 GERANIUM CIR 
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    City                 |    FOUNTAIN VALLEY
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    State                |    CA
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    Zip                  |    92708-1920
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    Country              |    US
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    Telephone            |    714-883-3017
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LICENSEE
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    Name                 |     DEVIN JOSHUA ANTONY 
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    Credential           |    
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    Telephone            |    714-883-3017
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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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