Organization
AGE CONNECTION CCA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILAGROS ASEJO EPHRAIM (OWNER)
(949) 326-3665
Entity
Organization
Contact information
Practice address
2835 PENASCO, SAN CLEMENTE, CA 92673-3559
(949) 492-1253
Mailing address
2835 PENASCO, SAN CLEMENTE, CA 92673-3559
(949) 492-1253
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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