Provider Demographics
NPI:1881402196
Name:ORTEGALUARES NURSING HOME LLC
Entity type:Organization
Organization Name:ORTEGALUARES NURSING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNARDINO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-342-3752
Mailing Address - Street 1:160 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-2607
Mailing Address - Country:US
Mailing Address - Phone:707-342-3752
Mailing Address - Fax:
Practice Address - Street 1:160 S 13TH ST
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2607
Practice Address - Country:US
Practice Address - Phone:707-342-3752
Practice Address - Fax:559-665-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility