| NPI | 1053021915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN JOHNSON Licensee 661-972-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2025-08-05 |