P & J Homes, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

UNDER PROCESS Issued in CA

Legal business name

P & J HOMES, LLC

Doing business as

Logan's Home

Practice address

7683 Heather Cir
Buena Park, CA 90620-1924

Phone

(714) 388-5545

Fax

(714) 752-6530

NPI assigned

Mar 24, 2014

Organization subpart

Yes

Parent organization

P & J HOMES, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Phillip Clemente Ulit

Title

President-Owner

Phone

(714) 388-5545

Specialties & licenses 1

Addresses

Other names 1

• Logan's Home Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G720

Legal name

LOGAN'S HOME

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Apr 24, 2015

Last certification

May 2, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

7683 Heather Cir
Buena Park, CA 90620

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

P J Homes LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1144647512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7683 HEATHER CIR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906201924",
            "telephone_number": "714-388-5545",
            "fax_number": "714-752-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7683 HEATHER CIR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906201924",
            "telephone_number": "714-388-5545",
            "fax_number": "714-752-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P & J HOMES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "P & J HOMES, LLC",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "ULIT",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CLEMENTE",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "714-388-5545",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "UNDER PROCESS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan's Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessie Jesusyesenia Ortiz
• Eliza Tinio Ortizluis, LVN
• Henry Ota, PHARMD
• Rima Othman
• Carol Overduin, OTR/L
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• P.M. Zakhary DDS, BPDC
• Pacific Care Medical Group, Inc.
• Pacific Medical Supplies and Services, Inc.

• Nursing Facility/Intermediate Care Facility in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.