Fountain Valley Home

LBN: Rai Care Centers Of Southern California I Llc
Fountain Valley Home is an health care organization with primary practice located at 17197 Newhope St Suite E, Fountain Valley CA 92708-4228. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Rai Care Centers Of Southern California I Llc can be contacted via phone (714) 751-1064, or through Fawcett, Mark R via phone (781) 699-9000.

Contact Information

Primary practice address
17197 Newhope St Suite E Fountain Valley CA 92708-4228
Phone: (714) 751-1064
Fax: (714) 751-1098
Website:
Map and Directions
Authorized official contact:
Name: Fawcett, Mark R
Phone: (781) 699-9000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1255636841
LBN Legal business name Rai Care Centers Of Southern California I Llc
DBA Doing business as Fountain Valley Home
Authorized official Fawcett, Mark R
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 13th, 2011
Last updated Sep 26th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255636841 NPPES
California MEDICAID 1255635841

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