Healthcare Provider Details

I. General information

NPI: 1326698564
Provider Name (Legal Business Name): DEL RIO CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4171 CAMINO DEL RIO S
SAN DIEGO CA
92108-4103
US

IV. Provider business mailing address

4171 CAMINO DEL RIO S
SAN DIEGO CA
92108-4103
US

V. Phone/Fax

Practice location:
  • Phone: 619-283-2226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SCOTT KIRBY
Title or Position: CEO
Credential:
Phone: 619-201-5888