Provider Demographics
NPI:1699563510
Name:THE HIBISCUS HOME LLC
Entity type:Organization
Organization Name:THE HIBISCUS HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:UKARJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-236-6787
Mailing Address - Street 1:22455 NEEDLES ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2654
Mailing Address - Country:US
Mailing Address - Phone:661-236-6787
Mailing Address - Fax:
Practice Address - Street 1:14555 FIGUERAS RD
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-4405
Practice Address - Country:US
Practice Address - Phone:661-236-6787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility