Provider Demographics
NPI:1831527316
Name:MLSG CORP
Entity type:Organization
Organization Name:MLSG CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-707-5059
Mailing Address - Street 1:23331 EL TORO RD
Mailing Address - Street 2:SUITE 217 B
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4891
Mailing Address - Country:US
Mailing Address - Phone:949-707-5059
Mailing Address - Fax:949-203-2177
Practice Address - Street 1:13331 EL TORO ROAD
Practice Address - Street 2:SUITE 217 B
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630
Practice Address - Country:US
Practice Address - Phone:949-707-5059
Practice Address - Fax:949-203-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based