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NPI Code Detail

MEDICARE: DEL'S HAVEN IV, INC

MEDICARE: DEL'S HAVEN IV, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1194596155
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEL'S HAVEN IV, INC
Provider Business Mailing Address
First Line : 23822 STILLWATER LN
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-1706
Country : US
Telephone Number : 949-402-3370
Fax Number : 949-218-6954
Provider Business Practice Location Address
First Line : 23822 STILLWATER LN
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-1706
Country : US
Telephone Number : 949-402-3370
Fax Number : 949-218-6954
Authorized Official
Title or Position : CEO
Name : DIANNA MANALO
Credential :
Telephone Number : 949-258-2063
Provider Enumeration Date : 01/09/2024
Last Update Date : 01/16/2024

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Directions to “DEL'S HAVEN IV, INC ” Practice Location

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