Provider Demographics
NPI:1720243199
Name:PUENTE PARTNERS,LLC
Entity Type:Organization
Organization Name:PUENTE PARTNERS,LLC
Other - Org Name:VICTORIA CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-577-3880
Mailing Address - Street 1:3050 SATURN ST
Mailing Address - Street 2:STE201
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-6221
Mailing Address - Country:US
Mailing Address - Phone:714-577-3880
Mailing Address - Fax:714-577-3892
Practice Address - Street 1:3541 PUENTE AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-5534
Practice Address - Country:US
Practice Address - Phone:626-962-1043
Practice Address - Fax:626-337-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA950000077314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility