Provider Demographics
NPI:1922619295
Name:ANL FACILITY HOME INC
Entity Type:Organization
Organization Name:ANL FACILITY HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTED LIVING -ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZVIMINDA
Authorized Official - Middle Name:AGRES
Authorized Official - Last Name:BULOSAN
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:562-466-9268
Mailing Address - Street 1:12073 HIGHDALE ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6629
Mailing Address - Country:US
Mailing Address - Phone:562-466-9268
Mailing Address - Fax:562-484-3468
Practice Address - Street 1:12073 HIGHDALE ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-6629
Practice Address - Country:US
Practice Address - Phone:562-466-9268
Practice Address - Fax:562-484-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility