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General NPI Number Information
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NPI Number | 1033880828
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Entity Type | Organization
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Legal Business Name | HUMBLE HAVEN RCFE II
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 37801 RUDALL AVE
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City | PALMDALE
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State | CA
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Zip | 93550-5555
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Country | US
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Telephone | 661-526-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 37801 RUDALL AVE
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City | PALMDALE
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State | CA
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Zip | 93550-5555
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Country | US
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Telephone | 661-526-3200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE DE LAS ALAS
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Credential |
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Telephone | 707-688-5606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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