Organization
C & R GUEST HOMES, INC
Active
Other names
CRESCENT HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSALINDA CLEMENTE ULIT (LICENSEE/ADMINISTRATOR)
(714) 496-9990
Entity
Organization
Contact information
Practice address
7694 HEATHER CIR, BUENA PARK, CA 90620-1924
(714) 496-9990
(714) 739-4371
Mailing address
7694 HEATHER CIR., BUENA PARK, CA 90620-1924
(714) 496-9990
(714) 739-4371
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05GP1904
MEDICAL PROVIDER NUMBER
CA
Enumeration date
02/08/2010
Last updated
02/08/2010
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