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1184223943
QUINCY EUGENE MCCULLOUGH
VICTORVILLE, CA
NPI
1184223943
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
310400000X Assisted Living Facility
(Licence: CA 361800175)
Enumeration Date
2020-10-22
Last Update Date
2020-10-22
Business Address
Mr. QUINCY EUGENE MCCULLOUGH
15693 CHOCTAW ST
VICTORVILLE, CA 92395-5531
Phone number: 442-229-2100
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Mailing Address
Mr. QUINCY EUGENE MCCULLOUGH
15693 CHOCTAW ST
VICTORVILLE, CA 92395-5531
Phone number: 442-229-2100
Copy
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