Provider Demographics
NPI:1376776617
Name:ORANGE HEALTHCARE & WELLNESS CENTRE LLC
Entity Type:Organization
Organization Name:ORANGE HEALTHCARE & WELLNESS CENTRE LLC
Other - Org Name:ORANGE HEALTHCARE AND WELLNESS CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:RECHNITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-800-1191
Mailing Address - Street 1:920 W LA VETA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4302
Mailing Address - Country:US
Mailing Address - Phone:714-633-3568
Mailing Address - Fax:714-633-3746
Practice Address - Street 1:920 W LA VETA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4302
Practice Address - Country:US
Practice Address - Phone:714-633-3568
Practice Address - Fax:714-633-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055252OtherMEDICARE
CAZZT05252HMedicaid
CA055252OtherMEDICARE