Provider Demographics
NPI:1356704100
Name:WOODLAND GARDEN I & II
Entity type:Organization
Organization Name:WOODLAND GARDEN I & II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ENCABO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-805-1565
Mailing Address - Street 1:574 ECHO LN
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4205
Mailing Address - Country:US
Mailing Address - Phone:760-805-1565
Mailing Address - Fax:
Practice Address - Street 1:1717 KATY PL
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-1855
Practice Address - Country:US
Practice Address - Phone:760-805-1565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374602295310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility