Provider Demographics
NPI:1801672605
Name:PH SENIOR CARE LLC
Entity type:Organization
Organization Name:PH SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:ELEGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-464-3891
Mailing Address - Street 1:40 BOYD RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3707
Mailing Address - Country:US
Mailing Address - Phone:925-286-5727
Mailing Address - Fax:925-932-3060
Practice Address - Street 1:40 BOYD RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3707
Practice Address - Country:US
Practice Address - Phone:925-286-5727
Practice Address - Fax:925-932-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility