Provider Demographics
NPI:1699650754
Name:PSALM 23 ASSISTED LIVING II
Entity type:Organization
Organization Name:PSALM 23 ASSISTED LIVING II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IIRMA
Authorized Official - Middle Name:GAWARAN
Authorized Official - Last Name:LACONSAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-610-8455
Mailing Address - Street 1:13536 DEL MARINO AVE
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-5008
Mailing Address - Country:US
Mailing Address - Phone:858-610-8455
Mailing Address - Fax:
Practice Address - Street 1:10176 EMBASSY WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-3446
Practice Address - Country:US
Practice Address - Phone:858-610-8455
Practice Address - Fax:858-544-6966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSALM 23 ASSISTED LIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility