Basic Information
Provider Information
NPI: 1194821736
EntityType: 2
ReplacementNPI:  
OrganizationName: LVDN LTD.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: LAS VILLAS DEL NORTE HEALTH CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9619 CHESAPEAKE DR
Address2: SUITE 103
City: SAN DIEGO
State: CA
PostalCode: 921231368
CountryCode: US
TelephoneNumber: 8585654424
FaxNumber: 8585652428
Practice Location
Address1: 1335 LAS VILLAS WAY
Address2:  
City: ESCONDIDO
State: CA
PostalCode: 920261921
CountryCode: US
TelephoneNumber: 7607411046
FaxNumber: 7607410221
Other Information
ProviderEnumerationDate: 09/14/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BARNARD
AuthorizedOfficialFirstName: B.
AuthorizedOfficialMiddleName: RENEE
AuthorizedOfficialTitleorPosition: CHIEF OPERATING OFFICER
AuthorizedOfficialTelephone: 8585654424
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X CAY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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