| NPI | 1407230162 |
|---|---|
| Doing Business As | COUNTRY CLUB NORTH |
| Entity Type | Organization |
| Authorized Contact | BORIS SKURATOVICH President 323-610-2841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: CA 197609131) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-06-20 |