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Organization

IVY COTTAGES III

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARMEN RODRIGUEZ (OWNER/ADMINISTRATOR)
(714) 775-1128
Entity
Organization

Contact information

Practice address
16840 MOUNT EDEN ST, FOUNTAIN VALLEY, CA 92708-2518
(714) 775-1128
Mailing address
16840 MOUNT EDEN ST, FOUNTAIN VALLEY, CA 92708-2518
(714) 775-1128

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
05/10/2021
Last updated
05/18/2021
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