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General NPI Number Information
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NPI Number | 1659662260
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Entity Type | Organization
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Legal Business Name | SUMMERLIN CARE
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 14993 DEL DIABLO LN
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City | SAN DIEGO
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State | CA
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Zip | 92129-1522
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Country | US
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Telephone | 858-531-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 14993 DEL DIABLO LN
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City | SAN DIEGO
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State | CA
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Zip | 92129-1522
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SONIA SALAMI
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Credential |
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Telephone | 858-531-9039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 374603232
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License Number State | CA
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