| NPI | 1043050339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALIAS LAKE ANDREWS Owner/Administrator 909-750-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2024-05-25 |
| Last Update Date | 2024-05-25 |