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General NPI Number Information
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NPI Number | 1225448707
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Entity Type | Organization
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Legal Business Name | ELEANORE'S FRIENDS
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 23332 MILL CREEK DR STE 160
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7928
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Country | US
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Telephone | 949-215-2600
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Fax | 800-573-1179
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Provider Business Mailing Address
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Address Line | 23332 MILL CREEK DR STE 160
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7928
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Country | US
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Telephone | 949-215-2600
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Fax | 800-573-1179
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Authorized Official
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Title or Position | FOUNDER
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Name | KEITH N MALLOS
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Credential |
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Telephone | 949-922-9929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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