Provider Demographics
NPI:1639955172
Name:WILLOWVIEW HOME TWO LLC
Entity Type:Organization
Organization Name:WILLOWVIEW HOME TWO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:EMALYN
Authorized Official - Middle Name:BILOG
Authorized Official - Last Name:ANGUIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-667-5411
Mailing Address - Street 1:44148 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4242
Mailing Address - Country:US
Mailing Address - Phone:818-667-5411
Mailing Address - Fax:661-418-6180
Practice Address - Street 1:44148 12TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4242
Practice Address - Country:US
Practice Address - Phone:818-667-5411
Practice Address - Fax:661-418-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility