Organization
A1 RESIDENTIAL CARE FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKTAR MOHAMED (CEO)
(612) 205-5094
Entity
Organization
Contact information
Practice address
2241 E ALDEN AVE, ANAHEIM, CA 92806
(612) 205-5094
Mailing address
2241 E ALDEN AVE, ANAHEIM, CA 92806
(612) 205-5094
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/19/2024
Last updated
12/13/2024
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