Provider Demographics
NPI:1053718783
Name:AJ'S SENIOR CARE HOME
Entity type:Organization
Organization Name:AJ'S SENIOR CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:BAENA
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:925-475-9941
Mailing Address - Street 1:3938 COWELL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-1709
Mailing Address - Country:US
Mailing Address - Phone:925-475-9941
Mailing Address - Fax:925-689-6888
Practice Address - Street 1:3938 COWELL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1709
Practice Address - Country:US
Practice Address - Phone:925-475-9941
Practice Address - Fax:925-689-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMEDICAIDMedicaid