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Organization
MONARCH HOME
Active
Organization
MONARCH HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERMINIO FERNANDEZ DELEON (OWNER)
(760) 842-5147
Entity
Organization
Contact information
Practice address
411 DENNIS DR, VISTA, CA 92083-7776
(760) 842-5147
(760) 842-5148
Mailing address
411 DENNIS DR, VISTA, CA 92083-7776
(760) 842-5147
(760) 842-5148
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
LTC80409F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC80409F
—
CA
Enumeration date
02/06/2008
Last updated
02/06/2008
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