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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK FISK (DIRECTOR / ADMINISTRATOR)
(949) 998-9191
Entity
Organization

Contact information

Practice address
26851 LA SIERRA DR, MISSION VIEJO, CA 92691-6049
(949) 998-9199
Mailing address
26881 LA SIERRA DR, MISSION VIEJO, CA 92691-6049
(949) 998-9199
(949) 998-9192

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
02/10/2025
Last updated
02/10/2025
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