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NPI 1588315162

NPI 1588315162 : KINDRED DAHLIA - A SISTER CARE GROUP LLC : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1588315162
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    Entity Type          |    Organization 
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    Legal Business Name  |    KINDRED DAHLIA - A SISTER CARE GROUP LLC 
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Dates
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    Enumeration Date     |    01/14/2022
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    Last Update Date     |    05/17/2022
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Provider Practice Location Address
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    Address Line         |    355 WOODMAN ST 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92114-4335
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    Country              |    US
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    Telephone            |    760-573-4099
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    355 WOODMAN ST 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92114-4335
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    Country              |    US
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    Telephone            |    760-573-4099
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MARILOU  DELACRUZ 
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    Credential           |    
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    Telephone            |    760-573-4099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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