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General NPI Number Information
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NPI Number | 1720696180
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Entity Type | Organization
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Legal Business Name | JEWEL HOMECARE LLC
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 20152 RIVERSIDE DR
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1325
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Country | US
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Telephone | 714-340-6697
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Fax |
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Provider Business Mailing Address
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Address Line | 5111 HAMER LN
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City | PLACENTIA
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State | CA
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Zip | 92870-3650
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Country | US
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Telephone | 714-340-6697
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JEHLA ROSE DELA ROSA
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Credential |
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Telephone | 949-394-8707
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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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