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General NPI Number Information
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NPI Number | 1245079052
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Entity Type | Organization
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Legal Business Name | VISTA COVE AT RANCHO MIRAGE
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Dates
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Enumeration Date | 05/21/2024
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 70201 MIRAGE COVE DR
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2906
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Country | US
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Telephone | 760-324-4604
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Fax | 760-318-4370
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Provider Business Mailing Address
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Address Line | 70201 MIRAGE COVE DR
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2906
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Country | US
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Telephone | 760-324-4604
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Fax | 760-318-4370
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JACKSON D POYFAIR
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Credential | LVN
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Telephone | 760-218-6724
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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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