Provider Demographics
NPI:1922433028
Name:WE CARE RESIDENTIAL HOME FOR THE ELDERLY
Entity Type:Organization
Organization Name:WE CARE RESIDENTIAL HOME FOR THE ELDERLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LUMPKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:OT
Authorized Official - Phone:661-435-9416
Mailing Address - Street 1:4707 W AVENUE K8
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5136
Mailing Address - Country:US
Mailing Address - Phone:661-435-9416
Mailing Address - Fax:
Practice Address - Street 1:4707 W AVENUE K8
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-5136
Practice Address - Country:US
Practice Address - Phone:661-435-9416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-08
Last Update Date:2013-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197608399310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility