Provider Demographics
NPI:1093466419
Name:GEORGE HOUSE RESIDENTIAL CARE FACILITY L.L.C
Entity Type:Organization
Organization Name:GEORGE HOUSE RESIDENTIAL CARE FACILITY L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:EMERALD
Authorized Official - Middle Name:ALINA
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:925-597-7182
Mailing Address - Street 1:2671 TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-7089
Mailing Address - Country:US
Mailing Address - Phone:925-303-9709
Mailing Address - Fax:
Practice Address - Street 1:2671 TORREY PINES DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-7089
Practice Address - Country:US
Practice Address - Phone:925-597-7182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty