1. Home
  2. Directory
  3. California
  4. Bellflower
  5. Custodial Care Facility
  6. NPI Profile

JACKY & ANGIE RESIDENTIAL CARE
NPI 1174880066
Custodial Care Facility - Adult Care Home in Bellflower, CA

Active since April 16, 2012
9332 GREENWELL ST, BELLFLOWER, CA 90706(310) 613-4211 Get Directions Write a Review

NPPES record last updated: April 16, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacky & Angie Residential Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKY & ANGIE RESIDENTIAL CARE (NPI 1174880066) is a healthcare organization registered as an adult care home in Bellflower, California and active in the NPI registry since April 2012. The organization lists Evangeline B Johnson, Adminstratrator, as its authorized official.

NPPES Registry Identity

NPI1174880066
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameJACKY & ANGIE RESIDENTIAL CARE
Location Address9332 GREENWELL STBellflower, CA 90706-3411
Mailing Address9332 Greenwell StreetBellflower, CA 90706 · (310) 613-4211
Phone(310) 613-4211
Organization SubpartNo
Authorized OfficialEvangeline B JohnsonAdminstratrator · (562) 925-7527
Enumeration DateApril 16, 2012
✔ NPI 1174880066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in CA · 304006088
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
9332 GREENWELL ST, Bellflower, CA 90706
Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGIE RESIDENTIAL HOME
Community Based Residential Treatment Facility, Mental Illness
9332 GREENWELL ST
BELLFLOWER, CA 90706
Los Angeles County (310) 613-4211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacky & Angie Residential Care's NPI number?

The NPI number for Jacky & Angie Residential Care is 1174880066. It was assigned to this organization in the NPPES registry on April 16, 2012.

Where is Jacky & Angie Residential Care located?

Jacky & Angie Residential Care is located at 9332 Greenwell St, Bellflower, CA 90706. The listed phone number is (310) 613-4211.

What is Jacky & Angie Residential Care's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Jacky & Angie Residential Care was last updated on April 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.