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IRENE'S HOME LLC NPI 1063163905


NPI Information

NPI: 1063163905
Provider Name: IRENE'S HOME LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1916 SOUTH 43RD ST
SAN DIEGO, CA
ZIP 92113
Phone: (619) 538-7599
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IRENE'S HOME LLC is a substance abuse rehabilitation facility in San Diego, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. IRENE'S HOME LLC NPI is 1063163905. The provider is registered as an organization entity type.

The provider's business location address is:

1916 SOUTH 43RD ST
SAN DIEGO, CA
ZIP 92113
Phone: (619) 538-7599
Fax: (619) 393-0448

The provider's authorized official is Portia Smith .
The authorized official title is Ceo and has the following contact phone number (619) 538-7599.

The enumeration date for this NPI number is 1/12/2022 and was last updated on 1/12/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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