| NPI | 1306675806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON LAZARUS Administrator 760-600-9492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-07-31 |
| Last Update Date | 2024-07-31 |