Organization
PROMISES GUEST VILLAGE, INC.
Active
Other names
Promises Guest Village
Organization subpart
No
Provider details
NPI number
Authorized official
DANTE ENCARNACION (ADMINISTRATOR)
(714) 234-1148
Entity
Organization
Contact information
Practice address
1315 S ANAHEIM BLVD, ANAHEIM, CA 92805-6206
(714) 774-1544
(714) 635-0347
Mailing address
1315 S ANAHEIM BLVD, ANAHEIM, CA 92805-6206
(714) 774-1544
(714) 635-0347
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306000106
FACILITY LICENSE
CA
Enumeration date
07/22/2022
Last updated
07/22/2022
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