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General NPI Number Information
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NPI Number | 1982496444
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Entity Type | Organization
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Legal Business Name | EMERALD LIVING, LLC
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 6740 GARBER AVE
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City | SAN DIEGO
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State | CA
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Zip | 92139-3817
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Country | US
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Telephone | 619-858-5191
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Fax |
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Provider Business Mailing Address
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Address Line | 6740 GARBER AVENUE
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City | SAN DIEGO
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State | CA
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Zip | 92139
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Country | US
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Telephone | 619-858-5191
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Fax |
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Authorized Official
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Title or Position | LICENSEE/ADMINISTRATOR
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Name | EUNICE 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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