# GORDON LANE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gordon Lane Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205932126
- **Authorized official:** MRS. JEANNE M NELSON (AR MANAGER)
- **Authorized official phone:** (714) 577-3880

## Contact information

- **Practice address:** 1821 E CHAPMAN AVE, FULLERTON, CA 92831-4102
- **Practice address phone:** (714) 879-7301
- **Practice address fax:** (714) 224-3320
- **Mailing address:** 3050 SATURN ST, STE 201, BREA, CA 92821-6221
- **Mailing address phone:** (714) 577-3880
- **Mailing address fax:** (714) 577-3892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060000118 | CA | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 06/03/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55797F | — | CA |