Provider Demographics
NPI:1538978440
Name:ANAHEIM SENIOR CARE LLC
Entity type:Organization
Organization Name:ANAHEIM SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:KAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJPOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-290-1826
Mailing Address - Street 1:8232 BELLHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1913
Mailing Address - Country:US
Mailing Address - Phone:949-290-1826
Mailing Address - Fax:
Practice Address - Street 1:3341 W BALL RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3707
Practice Address - Country:US
Practice Address - Phone:949-290-1826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility