Provider Demographics
NPI:1194596155
Name:DEL'S HAVEN IV, INC
Entity type:Organization
Organization Name:DEL'S HAVEN IV, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-258-2063
Mailing Address - Street 1:23822 STILLWATER LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1706
Mailing Address - Country:US
Mailing Address - Phone:949-402-3370
Mailing Address - Fax:949-218-6954
Practice Address - Street 1:23822 STILLWATER LN
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1706
Practice Address - Country:US
Practice Address - Phone:949-402-3370
Practice Address - Fax:949-218-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility