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General NPI Number Information
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NPI Number | 1528799665
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Entity Type | Organization
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Legal Business Name | MIRAMAR HEALTH INC
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 24851 VIA SANTA CRUZ
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City | MISSION VIEJO
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State | CA
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Zip | 92692-2437
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Country | US
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Telephone | 949-997-1548
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Fax |
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Provider Business Mailing Address
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Address Line | 2165 HARBOR BLVD
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City | COSTA MESA
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State | CA
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Zip | 92627-2529
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Country | US
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Telephone | 949-997-1548
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TOM SAUER
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Credential |
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Telephone | 425-505-1394
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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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