Provider Demographics
NPI:1437855749
Name:BETTYS PLACE LLC
Entity Type:Organization
Organization Name:BETTYS PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORETTA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CRENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-821-1291
Mailing Address - Street 1:37182 SIERRA GROVE DR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-1887
Mailing Address - Country:US
Mailing Address - Phone:951-821-1291
Mailing Address - Fax:
Practice Address - Street 1:37182 SIERRA GROVE DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1887
Practice Address - Country:US
Practice Address - Phone:951-821-1291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness