Provider Demographics
NPI:1528438371
Name:AICF, LLC
Entity type:Organization
Organization Name:AICF, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-347-7100
Mailing Address - Street 1:28202 CABOT RD
Mailing Address - Street 2:412
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1271
Mailing Address - Country:US
Mailing Address - Phone:949-347-7100
Mailing Address - Fax:
Practice Address - Street 1:325 S BOYLE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-3812
Practice Address - Country:US
Practice Address - Phone:323-263-9655
Practice Address - Fax:323-263-2721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05A411Medicare Oscar/Certification