1528441888 NPI number — AMERICAN CARE EXCELLENCE CONGREGATE LIVING LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528441888 NPI number — AMERICAN CARE EXCELLENCE CONGREGATE LIVING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN CARE EXCELLENCE CONGREGATE LIVING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528441888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9253 RESEDA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHRIDGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91324-3137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-900-9074
Provider Business Mailing Address Fax Number:
818-699-1290

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18620 FRANKFORT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91324-4742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-900-9074
Provider Business Practice Location Address Fax Number:
818-699-1290
Provider Enumeration Date:
07/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CASTRO
Authorized Official First Name:
JEMAIMA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
818-900-9074

Provider Taxonomy Codes

  • Taxonomy code: 320700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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