Provider Demographics
NPI:1023690823
Name:MARKIES MANOR
Entity type:Organization
Organization Name:MARKIES MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BOARD & CARE
Authorized Official - Phone:714-204-1344
Mailing Address - Street 1:13602 YOSEMITE DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3032
Mailing Address - Country:US
Mailing Address - Phone:714-894-4508
Mailing Address - Fax:714-740-0509
Practice Address - Street 1:13602 YOSEMITE DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3032
Practice Address - Country:US
Practice Address - Phone:714-894-4508
Practice Address - Fax:714-740-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home