| NPI | 1033554514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COULSANSER JOHNSON Lvn 562-230-3354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 385H00000X Respite Care |
| 251T00000X PACE Provider Organization | |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CA VN192615) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2019-12-19 |