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General NPI Number Information
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NPI Number | 1437917051
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Entity Type | Organization
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Legal Business Name | NOVELLUS CLAIREMONT
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 5219 CLAIREMONT MESA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92117-2206
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Country | US
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Telephone | 406-493-5568
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 LAVA RIDGE CT STE 340
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City | ROSEVILLE
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State | CA
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Zip | 95661-2838
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Country | US
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Telephone | 406-493-5568
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Fax |
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Authorized Official
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Title or Position | OPERATIONS SPECIALIST
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Name | RHONDA B DOLCATER
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Credential |
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Telephone | 406-493-5568
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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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