Organization
ECLC RESIDENCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAPURISIMA DIZON-FRANCO CHANG (PRESIDENT)
(949) 642-2906
Entity
Organization
Contact information
Practice address
2279 AVALON ST., COSTA MESA, CA 92626-6446
(949) 642-2906
(949) 642-0622
Mailing address
2279 AVALON ST., COSTA MESA, CA 92626-6446
(949) 642-2906
(949) 642-0622
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
306002093
CA
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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