Organization
ECLC WAKE FOREST VILLA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELITA FRANCO DAVID R.N. (ADMINISTRATOR)
(714) 434-9489
Entity
Organization
Contact information
Practice address
233 WAKE FOREST RD., COSTA MESA, CA 92626-6446
(714) 434-9489
(949) 642-0622
Mailing address
233 WAKE FOREST RD., COSTA MESA, CA 92626-6446
(714) 434-9489
(949) 642-0622
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
306001960
CA
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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