Provider Demographics
NPI:1144904681
Name:DE MARILLAC LLC
Entity type:Organization
Organization Name:DE MARILLAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-683-6381
Mailing Address - Street 1:4200 CALLE REAL
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1454
Mailing Address - Country:US
Mailing Address - Phone:805-683-6381
Mailing Address - Fax:805-967-7508
Practice Address - Street 1:4020 CALLE REAL
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-4052
Practice Address - Country:US
Practice Address - Phone:805-563-1051
Practice Address - Fax:805-563-1046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. VINCENT'S INSTITUTION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage