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General NPI Number Information
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NPI Number | 1699308155
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Entity Type | Organization
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Legal Business Name | MILES PLACE, INC.
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 25451 ADRIANA ST
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3817
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Country | US
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Telephone | 949-458-7869
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Fax |
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Provider Business Mailing Address
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Address Line | 25751 CHRISANTA DR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5607
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Country | US
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Telephone | 949-273-9951
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Fax | 844-308-6564
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Authorized Official
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Title or Position | MANAGER
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Name | REINER AVENDANO
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Credential |
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Telephone | 949-273-9951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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