Organization
POSITIVE LIFESTYLES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE WHEELOCK (OWNER)
(661) 725-7960
Entity
Organization
Contact information
Practice address
422 BALBOA DR, DELANO, CA 93215-4006
(661) 725-7960
Mailing address
PO BOX 849, DELANO, CA 93216-0849
(661) 715-7960
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
120000428
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC80113G
LONG TERM CARE FACILITY
CA
Enumeration date
05/30/2008
Last updated
05/30/2008
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