Provider Demographics
NPI:1528705589
Name:ALL CARE GROUP LLC
Entity type:Organization
Organization Name:ALL CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SITI KHATIJAH
Authorized Official - Middle Name:MEDINA
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:562-881-9464
Mailing Address - Street 1:8770 WOODMAN AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-6540
Mailing Address - Country:US
Mailing Address - Phone:818-462-7085
Mailing Address - Fax:
Practice Address - Street 1:12778 JUDD ST
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-1380
Practice Address - Country:US
Practice Address - Phone:818-741-4010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities