Eclc Residence, Inc.

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

306002093 Issued in CA

Legal business name

ECLC RESIDENCE, INC.

Practice address

2279 Avalon St.
Costa Mesa, CA 92626-6446

Phone

(949) 642-2906

Fax

(949) 642-0622

NPI assigned

Aug 27, 2012

Last updated

Aug 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lapurisima Dizon-Franco Chang

Title

President

Phone

(949) 642-2906

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1982952842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 AVALON ST.",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266446",
            "telephone_number": "949-642-2906",
            "fax_number": "949-642-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 AVALON ST.",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266446",
            "telephone_number": "949-642-2906",
            "fax_number": "949-642-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECLC RESIDENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "LAPURISIMA",
        "authorized_official_middle_name": "DIZON-FRANCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-642-2906",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CA",
            "license": "306002093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Custodial Care Facility in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Custodial Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.