Provider Demographics
NPI:1598570780
Name:DM RETIREMENT HOME LLC
Entity type:Organization
Organization Name:DM RETIREMENT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-294-9129
Mailing Address - Street 1:18131 SONORA BROOK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1809
Mailing Address - Country:US
Mailing Address - Phone:818-370-6291
Mailing Address - Fax:818-280-4038
Practice Address - Street 1:2710 GREEN FALLS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1884
Practice Address - Country:US
Practice Address - Phone:818-294-9129
Practice Address - Fax:818-280-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility