Provider Demographics
NPI:1790875441
Name:MARGARET'S VILLA, INC.
Entity Type:Organization
Organization Name:MARGARET'S VILLA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:DIZON
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:949-768-8951
Mailing Address - Street 1:19 AURORE AVE
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2321
Mailing Address - Country:US
Mailing Address - Phone:949-916-1646
Mailing Address - Fax:949-916-1646
Practice Address - Street 1:23052 DUNE MEAR RD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-3933
Practice Address - Country:US
Practice Address - Phone:949-768-8951
Practice Address - Fax:949-916-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities