Provider Demographics
NPI:1457518045
Name:THE EPISCOPAL HOME COMMUNITIES
Entity Type:Organization
Organization Name:THE EPISCOPAL HOME COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-300-6203
Mailing Address - Street 1:C/O 1609 W VALLEY
Mailing Address - Street 2:BL #328
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2348
Mailing Address - Country:US
Mailing Address - Phone:626-300-6203
Mailing Address - Fax:626-281-2246
Practice Address - Street 1:1428 SOUTH MARENGO AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2348
Practice Address - Country:US
Practice Address - Phone:626-300-6203
Practice Address - Fax:626-281-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191501936310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARCF00033FMedicaid