Provider Demographics
NPI:1336903657
Name:JULIA'S COTTAGE LLC
Entity type:Organization
Organization Name:JULIA'S COTTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-453-7257
Mailing Address - Street 1:1822 AVOCADO RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6133
Mailing Address - Country:US
Mailing Address - Phone:760-453-7257
Mailing Address - Fax:
Practice Address - Street 1:1822 AVOCADO RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6133
Practice Address - Country:US
Practice Address - Phone:760-453-7257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility