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NPI Code Detail

MEDICARE: MEADOWBROOK VILLAGE CHRISTIAN RETIREMENT COMMUNITY

MEDICARE: MEADOWBROOK VILLAGE CHRISTIAN RETIREMENT COMMUNITY
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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1437520400
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEADOWBROOK VILLAGE CHRISTIAN RETIREMENT COMMUNITY
Provider Business Mailing Address
First Line : 100 HOLLAND GLN
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-1354
Country : US
Telephone Number : 760-746-2500
Fax Number :
Provider Business Practice Location Address
First Line : 100 HOLLAND GLN
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-1354
Country : US
Telephone Number : 760-746-2500
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARK MEMMELAAR
Credential :
Telephone Number : 760-746-2500
Provider Enumeration Date : 10/15/2015
Last Update Date : 10/15/2015

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Directions to “MEADOWBROOK VILLAGE CHRISTIAN RETIREMENT COMMUNITY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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