EAGLE GLEN CARE HOME LLC NPI 1710395777

NPI Information

  • NPI: 1710395777
  • Provider Name: EAGLE GLEN CARE HOME LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 1697 HONORS CIR
    CORONA, CA
    ZIP 92883
  • Phone: (951) 582-9230

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NPI Details

EAGLE GLEN CARE HOME LLC is an assisted living facility in Corona, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. EAGLE GLEN CARE HOME LLC NPI is 1710395777. The provider is registered as an organization entity type.

The provider's business location address is:

1697 HONORS CIR
CORONA, CA
ZIP 92883-757
Phone: (951) 582-9230
Fax: (951) 340-2740

The provider's authorized official is Restituto Calilung .
The authorized official title is Licensee and has the following contact phone number (714) 906-6046.

The enumeration date for this NPI number is 7/23/2014 and was last updated on 7/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility336426012CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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