Provider Demographics
NPI:1306690490
Name:MAYON BOARD AND CARE, INC.
Entity type:Organization
Organization Name:MAYON BOARD AND CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PANELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-812-3302
Mailing Address - Street 1:1804 CONCORD CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-1428
Mailing Address - Country:US
Mailing Address - Phone:925-812-3302
Mailing Address - Fax:925-825-4583
Practice Address - Street 1:1804 CONCORD CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-1428
Practice Address - Country:US
Practice Address - Phone:925-812-3302
Practice Address - Fax:925-825-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility