Provider Demographics
NPI:1629657440
Name:ANNISSA GEM CARE
Entity Type:Organization
Organization Name:ANNISSA GEM CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GIDEON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMPIADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-365-4155
Mailing Address - Street 1:825 LILAC DR
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-4728
Mailing Address - Country:US
Mailing Address - Phone:714-646-6750
Mailing Address - Fax:
Practice Address - Street 1:825 LILAC DR
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-4728
Practice Address - Country:US
Practice Address - Phone:714-646-6750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility