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General NPI Number Information
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NPI Number | 1225817430
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Entity Type | Organization
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Legal Business Name | ALLIANCE SENIOR LIVING INC.
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 26871 LA SIERRA DR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6049
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Country | US
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Telephone | 949-394-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 22785 BARLOVENTO
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City | MISSION VIEJO
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State | CA
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Zip | 92692-1303
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Country | US
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Telephone | 949-394-0066
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAFAEL TEEHANKEE
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Credential |
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Telephone | 949-394-0066
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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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