Provider Demographics
NPI:1518010214
Name:JURADO ENTERPRISES
Entity Type:Organization
Organization Name:JURADO ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:JURADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-772-9158
Mailing Address - Street 1:17870 CASTLETON ST STE 317
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-6716
Mailing Address - Country:US
Mailing Address - Phone:626-935-0606
Mailing Address - Fax:626-935-0415
Practice Address - Street 1:18284 BARROSO ST
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-4403
Practice Address - Country:US
Practice Address - Phone:626-964-5737
Practice Address - Fax:626-964-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC61029FOtherPROVIDER