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General NPI Number Information
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NPI Number | 1811398928
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Entity Type | Organization
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Legal Business Name | FLOBAR, LLC
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 3532 GOVERNOR DR
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City | SAN DIEGO
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State | CA
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Zip | 92122-2904
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Country | US
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Telephone | 858-412-6560
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Fax | 858-412-3520
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Provider Business Mailing Address
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Address Line | 3532 GOVERNOR DR
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City | SAN DIEGO
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State | CA
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Zip | 92122-2904
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Country | US
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Telephone | 858-412-6560
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Fax | 858-412-3520
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BARBARA OLEARY
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Credential | RN
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Telephone | 781-964-8299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 374603337
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License Number State | CA
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