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General NPI Number Information
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NPI Number | 1326367590
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Entity Type | Organization
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Legal Business Name | MARINA'S PLACE
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 8553 MELVIN AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4136
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Country | US
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Telephone | 818-341-3549
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Fax | 818-341-3549
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Provider Business Mailing Address
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Address Line | 8553 MELVIN AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4136
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Country | US
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Telephone | 818-341-3549
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Fax | 818-341-3549
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. AIDA U. ESTIVA
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Credential |
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Telephone | 310-741-9235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 222016
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License Number State | CA
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