Organization
A2 RESIDENTIAL CARE FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKTAR MOHAMED (LICENSEE)
(612) 205-5094
Entity
Organization
Contact information
Practice address
3132 W STONYBROOK DR, ANAHEIM, CA 92804-3108
(612) 205-5094
Mailing address
3132 W STONYBROOK DR, ANAHEIM, CA 92804-3108
(612) 205-5094
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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