Organization
ARK ANGEL, II LLC
Active
Other names
Bella Vista
Organization subpart
No
Provider details
NPI number
Authorized official
HAIDIE BAUTISTA (LICENSEE)
(510) 677-6561
Entity
Organization
Contact information
Practice address
1641 D ST, HAYWARD, CA 94541-4320
(510) 397-0751
Mailing address
28759 VISTA GRANDE DR, HAYWARD, CA 94544-6703
(510) 677-6561
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019201202
RESIDENTIAL CARE FOR THE ELDERLY
CA
Enumeration date
10/10/2022
Last updated
10/10/2022
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