| NPI | 1063988483 |
|---|---|
| Doing Business As | PROVEDENTIS DEI CARE HOME I |
| Entity Type | Organization |
| Authorized Contact | VANNI MARASIGAN Administrator 661-496-4380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |