SIGNATURE RESIDENCE, INC (NPI# 1063045391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063045391 |
| Entity Type | Organization |
| Organization Name | SIGNATURE RESIDENCE, INC |
| Practice Address |
2727 Wavecrest Dr Corona Del Mar CA 92625-1326 |
| Practice Telephone | 9492201412 |
| Mailing Telephone | 9492201412 |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | KOLALEH FARIS (PRESIDENT) |
| Authorized Official Telephone | 9495105968 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Signature Residence, Inc | Former Legal Business Name - Organization |
| Street Address |
2727 WAVECREST DR |
| City | CORONA DEL MAR |
| State | CA |
| Zip Code | 92625-1326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083192041 | Lisa Menaker Quinn | Marriage & Family Therapist | 2345 E. Coast Highway, Suite D, Corona Del Mar, CA 92625 | 2018-08-01 |
| 1205210945 | Kelly Mccann | Marriage & Family Therapist | 2721 East Pacific Coast Highway, Suite 209, Corona Del Mar, CA 92625 | 2015-07-13 |
| 1831501113 | Bert Shepley | Marriage & Family Therapist | 1111 Bayside Drive, Suite 212, Corona Del Mar, CA 92625 | 2014-05-21 |
| 1295157741 | Jamie Young | Marriage & Family Therapist | 505 Larkpur Ave, Corona Del Mar, CA 92625 | 2014-01-16 |
| 1225321185 | Miramar Health Inc | Substance Abuse Rehabilitation Facility | 435 Dahlia Avenue, Newport Beach, CA 92625 | 2011-05-25 |
| 1972745362 | Andrew W Spath | Dentist | 2121 E Coast Hwy Ste 290, Corona Del Mar, CA 92625 | 2009-03-31 |
| 1790934743 | James Hair | Dentist | 3800 E. Pacific Coast Hwy., #2, Corona Del Mar, CA 92625 | 2008-09-15 |
| 1912173006 | Kevin J Taylor Dds Inc | Dentist | 2716 East Coast Hwy, Corona Del Mar, CA 92625 | 2008-05-08 |
| 1306048939 | Stephen Douglas Hutchins | Chiropractor | 2101 E Coast Hwy, Corona Del Mar, CA 92625 | 2007-06-05 |
| 1619094893 | Burr Vonmaur | Plastic Surgery | 1101 Bayside Drive, Suite 100, Corona Del Mar, CA 92625 | 2007-03-23 |
| Find all providers in zip 92625 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588165 | Nana's Garden II | Assisted Living Facility | 25312 Ericson Way, Laguna Hills, CA 92653-5054 | 2020-11-03 |
| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | CORONA DEL MAR |
| Zip Code | 92625 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.