Provider Demographics
NPI:1407443849
Name:ELEONORS PLACE INC.
Entity Type:Organization
Organization Name:ELEONORS PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARYLL
Authorized Official - Middle Name:
Authorized Official - Last Name:AVENDANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-547-5377
Mailing Address - Street 1:24881 ALICIA PKWY
Mailing Address - Street 2:STE E#511
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4617
Mailing Address - Country:US
Mailing Address - Phone:949-547-5377
Mailing Address - Fax:
Practice Address - Street 1:24152 JAGGER ST
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-3658
Practice Address - Country:US
Practice Address - Phone:949-547-5377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility