Organization
IRENE'S HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PORTIA SMITH (CEO)
(619) 538-7599
Entity
Organization
Contact information
Practice address
1916 SOUTH 43RD ST, SAN DIEGO, CA 92113
(619) 538-7599
(619) 393-0448
Mailing address
1916 SOUTH 43RD ST, SAN DIEGO, CA 92113
(619) 538-7599
(619) 393-0448
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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