| NPI | 1194125658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARMANDO ELEGIO EDANG Administrator/Director Of Nursing 909-908-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CA 550002799) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-10 |