Provider Demographics
NPI:1134666456
Name:SILVER SOUL CHRONICLES, INC.
Entity Type:Organization
Organization Name:SILVER SOUL CHRONICLES, INC.
Other - Org Name:ANGELS CARE GUEST HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JABONERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-975-3025
Mailing Address - Street 1:805 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3832
Mailing Address - Country:US
Mailing Address - Phone:714-975-3025
Mailing Address - Fax:714-784-2515
Practice Address - Street 1:10212 MALINDA LN
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-2918
Practice Address - Country:US
Practice Address - Phone:714-975-3025
Practice Address - Fax:714-784-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306004737311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility