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General NPI Number Information
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NPI Number | 1396986675
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Entity Type | Organization
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Legal Business Name | TENDER LOVING MERCY
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 909 W VISTA WAY
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City | VISTA
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State | CA
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Zip | 92083-6278
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Country | US
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Telephone | 760-726-7833
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Fax | 760-726-7814
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Provider Business Mailing Address
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Address Line | 909 W VISTA WAY
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City | VISTA
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State | CA
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Zip | 92083-6278
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Country | US
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Telephone | 760-726-7833
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Fax | 760-726-7814
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. HEATHER ANNE NUGENT
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Credential |
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Telephone | 760-726-7833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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