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General NPI Number Information
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NPI Number | 1548293327
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Entity Type | Organization
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Legal Business Name | VILLA MARIN HOMEOWNERS ASSOCIATION
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 THORNDALE DRIVE
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone | 415-492-2405
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Fax | 415-499-8395
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Provider Business Mailing Address
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Address Line | 100 THORNDALE DRIVE
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City | SAN RAFAEL
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State | CA
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Zip | 94903
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Country | US
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Telephone | 415-492-2405
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Fax | 415-499-8395
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Authorized Official
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Title or Position | CEO
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Name | MR. DANIEL VIC WALKER
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Credential | MBA LPA
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Telephone | 415-492-2637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | CA
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