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General NPI Number Information
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NPI Number | 1972619104
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Entity Type | Organization
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Legal Business Name | ST. PAUL'S EPISCOPAL HOME, INC.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 235 NUTMEG ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-6201
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Country | US
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Telephone | 619-239-8687
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Fax | 619-239-1201
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Provider Business Mailing Address
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Address Line | 328 MAPLE ST
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City | SAN DIEGO
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State | CA
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Zip | 92103-6522
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Country | US
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Telephone | 619-239-6900
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Fax | 619-239-1256
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Authorized Official
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Title or Position | SENIOR ACCOUNTING MANAGER
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Name | SHEILAH MOLINA
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Credential |
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Telephone | 619-239-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 090000181
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License Number State | CA
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