=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801710413
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DM SABLAN HOLDINGS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2026
-----------------------------------------------------
Last Update Date | 08/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | SPRINGS PLAZA SUITE #4 CHALAN PALE ARNOLD RD. GUALO RAI
-----------------------------------------------------
City | SAIPAN
-----------------------------------------------------
State | MP
-----------------------------------------------------
Zip | 96950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 670-235-8378
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX: 515 GRB
-----------------------------------------------------
City | SAIPAN
-----------------------------------------------------
State | MP
-----------------------------------------------------
Zip | 96950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 670-235-8378
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DIEGO MANGLONA SABLAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 670-285-3784
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------