Provider Demographics
NPI:1457757965
Name:LALAINE'S II RESIDENTIAL CARE HOME FOR THE ELDERLY
Entity type:Organization
Organization Name:LALAINE'S II RESIDENTIAL CARE HOME FOR THE ELDERLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:PO
Authorized Official - Middle Name:WAN
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-812-8100
Mailing Address - Street 1:2844 SCANDIA WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4016
Mailing Address - Country:US
Mailing Address - Phone:916-977-0991
Mailing Address - Fax:916-999-0123
Practice Address - Street 1:2844 SCANDIA WAY
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4016
Practice Address - Country:US
Practice Address - Phone:916-977-0991
Practice Address - Fax:916-999-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347003661320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities