| NPI | 1144965872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY SIHAVONG VANNOY Owner/CEO 951-847-5476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-04-27 |