Organization
CARE BLUE WATER
Active
Other names
Maryknoll Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCES AMANDA UMALI (LICENSEE/ ADMINISTRATOR)
(805) 836-1556
Entity
Organization
Contact information
Practice address
531 WHITTEN WAY, PLACENTIA, CA 92870-2226
(805) 836-1556
Mailing address
38 VACAVILLE, IRVINE, CA 92602-0916
(805) 836-1556
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30605633
CCLD
CA
Enumeration date
07/11/2019
Last updated
07/11/2019
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