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General NPI Number Information
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NPI Number | 1336693100
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Entity Type | Organization
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Legal Business Name | EDELWEISS HOME INC.
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 296 PEBBLE HILL DR
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City | SANTA BARBARA
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State | CA
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Zip | 93111-1917
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Country | US
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Telephone | 805-845-5559
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Fax | 805-845-6020
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Provider Business Mailing Address
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Address Line | 7067 ARMSTRONG RD
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City | GOLETA
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State | CA
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Zip | 93117-4035
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Country | US
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Telephone | 805-845-5447
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Fax | 805-845-6020
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Authorized Official
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Title or Position | VICE-PRESIDENT/ADMINISTRATOR
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Name | MRS. MILDRED HUG-DEMONTEVERDE
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Credential |
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Telephone | 805-284-5870
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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 | 425801989
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License Number State | CA
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