Provider Demographics
NPI:1184010654
Name:FIRE DRAGON INVESTMENT, LLC.
Entity Type:Organization
Organization Name:FIRE DRAGON INVESTMENT, LLC.
Other - Org Name:OLIVIA ISABEL MANOR
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSALYNN
Authorized Official - Middle Name:PHUONG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-651-1131
Mailing Address - Street 1:21515 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-1947
Mailing Address - Country:US
Mailing Address - Phone:310-328-5116
Mailing Address - Fax:310-328-9170
Practice Address - Street 1:21515 FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-1947
Practice Address - Country:US
Practice Address - Phone:310-328-5116
Practice Address - Fax:310-328-9170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-12
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1986017663104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness