Organization
PHV 1 RCFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL LACSON (LICENSEE)
(714) 519-5878
Entity
Organization
Contact information
Practice address
1300 N WANDA RD, ORANGE, CA 92867-5327
(714) 519-5878
Mailing address
1300 N WANDA RD, ORANGE, CA 92867-5327
(714) 519-5878
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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