Provider Demographics
NPI:1750876413
Name:MIRAMAR HEALTH, INC.
Entity type:Organization
Organization Name:MIRAMAR HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OR UR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER-DELVALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-214-9335
Mailing Address - Street 1:812 EMERALD BAY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1273
Mailing Address - Country:US
Mailing Address - Phone:954-214-9335
Mailing Address - Fax:
Practice Address - Street 1:850 GLENNEYRE ST
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2733
Practice Address - Country:US
Practice Address - Phone:954-214-9335
Practice Address - Fax:866-675-5593
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIRAMAR HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility