La Vine House

LBN: Rockcreek, Inc.
La Vine House is an health care organization with primary practice located at 9939 La Vine St , Alta Loma CA 91701-5909. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Rockcreek, Inc. can be contacted via phone (714) 537-3252, or through Mattingly, Angie via phone (502) 630-7425.

Contact Information

Primary practice address
9939 La Vine St Alta Loma CA 91701-5909
Phone: (714) 537-3252
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mattingly, Angie
Phone: (502) 630-7425

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1841327285
LBN Legal business name Rockcreek, Inc.
DBA Doing business as La Vine House
Authorized official Mattingly, Angie
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2007
Last updated Jun 19th, 2024 - about 2 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 1841327285 NPPES
California MEDICAID LTC60539F

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