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General NPI Number Information
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NPI Number | 1922619295
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Entity Type | Organization
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Legal Business Name | ANL FACILITY HOME INC
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 12073 HIGHDALE ST
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City | NORWALK
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State | CA
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Zip | 90650-6629
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Country | US
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Telephone | 562-466-9268
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Fax | 562-484-3468
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Provider Business Mailing Address
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Address Line | 12073 HIGHDALE ST
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City | NORWALK
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State | CA
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Zip | 90650-6629
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Country | US
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Telephone | 562-466-9268
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Fax | 562-484-3468
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Authorized Official
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Title or Position | ASSISTED LIVING -ADMINISTRATOR
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Name | MRS. LUZVIMINDA AGRES BULOSAN
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Credential | ADMINISTRATOR
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Telephone | 562-466-9268
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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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