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General NPI Number Information
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NPI Number | 1598106544
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Entity Type | Organization
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Legal Business Name | RESTFUL HOMES, INC.
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Dates
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Enumeration Date | 07/07/2013
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Last Update Date | 07/07/2013
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Provider Practice Location Address
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Address Line | 1266 PLEIADES DR
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City | VISTA
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State | CA
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Zip | 92084-6531
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Country | US
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Telephone | 760-598-9697
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Fax |
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Provider Business Mailing Address
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Address Line | 1266 PLEIADES DR
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City | VISTA
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State | CA
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Zip | 92084-6531
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Country | US
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Telephone | 760-598-9697
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JEAN LACOMBE
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Credential | PHYSICIAN ASSISTANT
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Telephone | 760-598-9697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 374600114
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License Number State | CA
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