Organization
VERSA CARE HOME, LLC
Active
Other names
VERSA CARE HOME 1
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CECILY REGINE AGUILA (ADMINISTRATOR)
(714) 801-5208
Entity
Organization
Contact information
Practice address
1576 E SPRUCE ST, PLACENTIA, CA 92870-9406
(714) 801-5208
(714) 646-9217
Mailing address
1576 SPRUCE STREET, PLACENTIA, CA 92870
(714) 801-5208
(714) 646-9217
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
306004198
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306004198
DEPARTMENT OF SOCIAL SERVICES CCLD
CA
Enumeration date
03/01/2017
Last updated
03/01/2017
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