| NPI | 1578044350 |
|---|---|
| Doing Business As | COUNTRY CLUB MANOR |
| Entity Type | Organization |
| Authorized Contact | GLENN STEVEN SILVERMAN Member 415-789-8858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: CA 342700301) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-08-28 |