Provider Demographics
NPI:1376130047
Name:DEDICATED TO SERVICE, INC.
Entity Type:Organization
Organization Name:DEDICATED TO SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERMINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-683-8736
Mailing Address - Street 1:22871 RIDGE ROUTE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-3675
Mailing Address - Country:US
Mailing Address - Phone:949-683-8736
Mailing Address - Fax:
Practice Address - Street 1:24961 SOUTHPORT ST
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4924
Practice Address - Country:US
Practice Address - Phone:949-305-6133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home