Organization
CAREMERIDIAN, LLC
Active
Parent organization
NATIONAL MENTOR HEALTHCARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATIONAL MENTOR HEALTHCARE, LLC
Authorized official
MRS. CRYSTAL DAWN IMMERMAN (MANAGER OF ADMINISTRATION)
(949) 263-6632
Entity
Organization
Contact information
Practice address
2960 BERNARDO AVE, ESCONDIDO, CA 92029-6610
(760) 739-8255
(760) 739-8214
Mailing address
18A JOURNEY, SUITE 200, ALISO VIEJO, CA 92656-5342
(949) 263-6632
(949) 266-8679
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
080000357
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080000357
STATE DHS LICENSE #
CA
05
—
HCB00005F
—
CA
Enumeration date
01/31/2007
Last updated
09/12/2008
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