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General NPI Number Information
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NPI Number | 1457757965
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Entity Type | Organization
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Legal Business Name | LALAINE'S II RESIDENTIAL CARE HOME FOR THE ELDERLY
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 2844 SCANDIA WAY
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City | CARMICHAEL
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State | CA
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Zip | 95608-4016
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Country | US
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Telephone | 916-977-0991
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Fax | 916-999-0123
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Provider Business Mailing Address
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Address Line | 2844 SCANDIA WAY
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City | CARMICHAEL
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State | CA
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Zip | 95608-4016
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Country | US
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Telephone | 916-977-0991
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Fax | 916-999-0123
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISS PO WAN LAU
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Credential |
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Telephone | 916-812-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 347003661
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License Number State | CA
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