Provider Demographics
NPI:1790353563
Name:LANCEA CAPSULE CORPORATION
Entity Type:Organization
Organization Name:LANCEA CAPSULE CORPORATION
Other - Org Name:LA HABRA PLAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-989-8633
Mailing Address - Street 1:2630 RAINIER WAY
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3527
Mailing Address - Country:US
Mailing Address - Phone:310-989-8633
Mailing Address - Fax:
Practice Address - Street 1:2630 RAINIER WAY
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3527
Practice Address - Country:US
Practice Address - Phone:310-989-8633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility