Mirabel Lodge
NPI #1366168296 in Forestville, California
Provider Information
- NPI Number
- 1366168296
- Entity Type
- Organization
- Organization Name
- Mirabel Lodge
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Oct 12, 2022
- Last Updated
- Oct 12, 2022
Practice Location
- Address
- 6950 MIRABEL RD
- City
- Forestville
- State
- California
- ZIP Code
- 95436-9534
- Phone
- (415) 264-5486
Authorized Official
- Name
- ALEXANDER VARSHAVSKY
- Title
- LICENSEE
- Phone
- (415) 264-5486
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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