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General NPI Number Information
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NPI Number | 1922089119
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Entity Type | Organization
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Legal Business Name | ATLAS CARE ENTERPRISES INCORPORATED
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 101 S FICKETT ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-4017
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Country | US
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Telephone | 323-261-8108
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Fax | 323-261-8213
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Provider Business Mailing Address
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Address Line | 101 S FICKETT ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-4017
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Country | US
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Telephone | 323-261-8108
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Fax | 323-261-8213
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. FIL V CONSOLACION
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Credential | NHA5683
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Telephone | 323-261-8108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 970000035
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License Number State | CA
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