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General NPI Number Information
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NPI Number | 1790875441
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Entity Type | Organization
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Legal Business Name | MARGARET'S VILLA, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23052 DUNE MEAR RD
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City | LAKE FOREST
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State | CA
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Zip | 92630-3933
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Country | US
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Telephone | 949-768-8951
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Fax | 949-916-1646
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Provider Business Mailing Address
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Address Line | 19 AURORE AVE
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2321
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Country | US
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Telephone | 949-916-1646
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Fax | 949-916-1646
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Authorized Official
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Title or Position | VICE PRESIDENT/ADMINISTRATOR
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Name | LILIBETH DIZON ORTIZ
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Credential | RN
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Telephone | 949-768-8951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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