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1164859781
MARIO MAX GRANVILLE
LONG BEACH, CA
NPI
1164859781
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: CA 2254000000X)
Enumeration Date
2013-09-27
Last Update Date
2013-09-27
Business Address
Mr. MARIO MAX GRANVILLE
456 ELM AVE
LONG BEACH, CA 90802-2426
Phone number: 562-437-6717
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Mailing Address
Mr. MARIO MAX GRANVILLE
456 ELM AVE
LONG BEACH, CA 90802-2426
Phone number: 562-437-6717
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