| NPI | 1154180222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIET MENDOZA Admministrator 619-228-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-03-18 |