Organization
MHA VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RENEE LIMON (STUDENT NURSE)
(661) 537-4772
Entity
Organization
Contact information
Practice address
456 ELM AVE, LONG BEACH, CA 90802-2426
(562) 437-6717
(562) 437-5072
Mailing address
2024 FULLERTON AVE, COSTA MESA, CA 92627-2105
(661) 537-4772
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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