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General NPI Number Information
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NPI Number | 1861118242
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Entity Type | Organization
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Legal Business Name | MAYFLOWER HOME CARE LLC
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 7404 SKYLINE DR
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City | SAN DIEGO
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State | CA
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Zip | 92114-4621
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Country | US
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Telephone | 619-230-5328
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Fax |
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Provider Business Mailing Address
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Address Line | 7404 SKYLINE DR
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City | SAN DIEGO
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State | CA
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Zip | 92114-4621
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Country | US
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Telephone | 619-230-5328
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | EUNICE PAGULAYAN AMBAL
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Credential |
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Telephone | 619-888-2542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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