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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
302 BALBOA DR, DELANO, CA 93215-4007
(661) 725-7960
Mailing address
PO BOX 849, 302 BALBOA DRIVE, DELANO, CA 93216-0849
(661) 725-7960
(661) 725-6876

Taxonomy

Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
12-0000428
CA
310500000X
Mental Illness Intermediate Care Facility
Primary
12-0000429
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LTC80113G
LONG-TERM CARE FACILITY
CA
01
LTC80114G
LONG-TERM CARE FACILITY
CA
Enumeration date
01/25/2007
Last updated
05/07/2008
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