Healthcare Provider Details

I. General information

NPI: 1033644570
Provider Name (Legal Business Name): MONZE SENIOR RESIDENTIAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1143 PURDY ST
SPRING VALLEY CA
91977-4754
US

IV. Provider business mailing address

1143 PURDY ST
SPRING VALLEY CA
91977-4754
US

V. Phone/Fax

Practice location:
  • Phone: 619-464-1936
  • Fax: 619-286-0757
Mailing address:
  • Phone: 619-464-1936
  • Fax: 619-286-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: MAGALY NOEMI FLORES
Title or Position: PRESIDENT
Credential:
Phone: 619-464-1936