Provider Demographics
NPI:1225448707
Name:ELEANORE'S FRIENDS
Entity Type:Organization
Organization Name:ELEANORE'S FRIENDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:N
Authorized Official - Last Name:MALLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-922-9929
Mailing Address - Street 1:23332 MILL CREEK DR STE 160
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7928
Mailing Address - Country:US
Mailing Address - Phone:949-215-2600
Mailing Address - Fax:800-573-1179
Practice Address - Street 1:23332 MILL CREEK DR STE 160
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7928
Practice Address - Country:US
Practice Address - Phone:949-215-2600
Practice Address - Fax:800-573-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care