| NPI | 1174396733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN METZNER Administrative Assistant 909-837-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2023-11-03 |