MAYBERRY'S NPI 1629964341

NPI Information

  • NPI: 1629964341
  • Provider Name: MAYBERRY'S
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 14516 TACUBA DR
    LA MIRADA, CA
    ZIP 90638
  • Phone: (310) 650-0545

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NPI Details

MAYBERRY'S is an assisted living facility in La Mirada, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. MAYBERRY'S NPI is 1629964341. The provider is registered as an organization entity type.

The provider's business location address is:

14516 TACUBA DR
LA MIRADA, CA
ZIP 90638-043
Phone: (310) 650-0545

The provider's authorized official is Debra Ballou-harding .
The authorized official title is Owner and has the following contact phone number (310) 650-0545.

The enumeration date for this NPI number is 6/17/2025 and was last updated on 6/17/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessNo
23104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesNo
3311ZA0620XCustodial Care FacilityAdult Care HomeNo
4320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
5310400000XAssisted Living 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: 11/21/2025

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