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General NPI Number Information
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NPI Number | 1750876413
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Entity Type | Organization
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Legal Business Name | MIRAMAR HEALTH, INC.
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 850 GLENNEYRE ST
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2733
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Country | US
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Telephone | 954-214-9335
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Fax | 866-675-5593
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Provider Business Mailing Address
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Address Line | 812 EMERALD BAY
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-1273
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Country | US
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Telephone | 954-214-9335
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OR UR
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Name | SUSAN SINGER-DELVALLE
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Credential |
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Telephone | 954-214-9335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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