Provider Demographics
NPI:1619424553
Name:REHABILITATION CENTER OF ORANGE COUNTY LLC
Entity Type:Organization
Organization Name:REHABILITATION CENTER OF ORANGE COUNTY LLC
Other - Org Name:HEALTHCARE CENTER OF ORANGE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTACT PERSON
Authorized Official - Prefix:
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-346-0300
Mailing Address - Street 1:107 W LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2809
Mailing Address - Country:US
Mailing Address - Phone:626-658-7344
Mailing Address - Fax:323-846-5788
Practice Address - Street 1:9021 KNOTT AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4138
Practice Address - Country:US
Practice Address - Phone:714-826-2330
Practice Address - Fax:714-922-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000149314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC70154FMedicaid
CAZZT05674IMedicaid
CA055674Medicare Oscar/Certification