MEDICARE: LA ORANA VENTURES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)
2	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1649041286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA ORANA VENTURES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 212874
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91921-2874
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 S ORANGE AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-7522
Country	:	US
Telephone Number	:	951-392-0827
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM JENKINS
Credential	:	NHA
Telephone Number	:	951-392-0827

Provider Enumeration Date	:	01/11/2024
Last Update Date	:	01/11/2024

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Directions to “LA ORANA VENTURES, LLC ” Practice Location

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