Provider Demographics
NPI:1568771244
Name:DAVID'S HOUSE, LLC
Entity Type:Organization
Organization Name:DAVID'S HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MRAULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-725-9009
Mailing Address - Street 1:3 CEDAR RDG
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-3601
Mailing Address - Country:US
Mailing Address - Phone:949-725-9009
Mailing Address - Fax:949-769-3434
Practice Address - Street 1:3 CEDAR RDG
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-3601
Practice Address - Country:US
Practice Address - Phone:949-725-9009
Practice Address - Fax:949-769-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities