Renester Villa, LLC – Adult Day Care Clinic/Center

Key facts

NPI: 1154538577
Entity type: Organization (NPI type 2)
Primary specialty: Adult Day Care Clinic/Center 261QA0600X
Legal business name: RENESTER VILLA, LLC
Practice address: 437 Grape Ave
Holtville, CA 92250-1505
Phone: (760) 356-4375
Fax: (760) 356-4352
NPI assigned: May 16, 2007
Organization subpart: No

Authorized official

Name: Ms. Wendy Debra Jensen
Title: Adminstrator
Phone: (760) 356-4375

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Maryrose Bryndzia Delarosa, OTR Occupational Therapist · Fort Bragg, NC · NPI 1407184484

NPD (past)

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Day Care Clinic/Center	261QA0600X			Yes

Addresses

Primary practice location

437 Grape Ave
Holtville, CA 92250-1505

Mailing address

708 E 5TH St
Holtville, CA 92250-1514
Phone (760) 356-4375

Other identifiers

Identifier	Type	State	Issuer
ADU70412F	Medicaid	CA

Other names

Blossom Valley Inn Adult Day Health Care Center Doing business as

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Vincent V. Soun, MD MPH MAJOR

All providers in Holtville, CA · Adult Day Care Clinic/Center in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.