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Organization

A FAITHFUL HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. THERESA SERAPIO KHOLOMA (ADMINISTRATOR/LICENSEE)
(714) 300-8055
Entity
Organization

Contact information

Practice address
26642 SALAMANCA DR, MISSION VIEJO, CA 92691-4923
(949) 382-2818
(949) 382-2818
Mailing address
26642 SALAMANCA DR, MISSION VIEJO, CA 92691-4923
(949) 382-2818
(949) 382-2818

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
306004810
CA

Other

Enumeration date
06/24/2016
Last updated
06/24/2016
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