Provider Demographics
NPI:1326636960
Name:PLEASANT HAVEN HOME CARE
Entity Type:Organization
Organization Name:PLEASANT HAVEN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOIME
Authorized Official - Middle Name:
Authorized Official - Last Name:PABALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-321-5939
Mailing Address - Street 1:129 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3072
Mailing Address - Country:US
Mailing Address - Phone:213-321-5939
Mailing Address - Fax:
Practice Address - Street 1:129 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3072
Practice Address - Country:US
Practice Address - Phone:213-321-5939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility