| NPI | 1184030629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA MILLER Licensee 661-944-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CA 191221245) |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2014-07-04 |