OrganizationActive
Eclc Wake Forest Villa, Inc.
NPI 1619225570 · Custodial Care Facility · Costa Mesa, CA
Provider details
- NPI number
- 1619225570
- Entity type
- Organization
- Primary specialty
- Custodial Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Angelita David, Administrator(714) 434-9489
- License
- 306001960 (CA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
233 Wake Forest Rd.
Costa Mesa, CA 92626-6446
Phone: (714) 434-9489
Fax: (949) 642-0622
Approximate (ZIP-level) locationGet directions
Mailing address
233 Wake Forest Rd.
Costa Mesa, CA 92626-6446
Registry dates
- Enumerated
- 2012-08-27
- Last updated
- 2012-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.