Healthcare Provider Details

I. General information

NPI: 1679341176
Provider Name (Legal Business Name): DEL MONTE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 DAVID AVE
PACIFIC GROVE CA
93950-5507
US

IV. Provider business mailing address

1229 DAVID AVE
PACIFIC GROVE CA
93950-5507
US

V. Phone/Fax

Practice location:
  • Phone: 314-495-1867
  • Fax:
Mailing address:
  • Phone: 314-495-1867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW DELBRUEGGE
Title or Position: OFFICER
Credential:
Phone: 314-495-1867