NPI | 1609913409 |
---|---|
Doing Business As | JACK SURNOW HOUSE |
Entity Type | Organization |
Authorized Contact | DAVID C THORNTON Executive Director 760-329-6471 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CA 550000120) |
Enumeration Date | 2007-01-31 |
Last Update Date | 2020-08-22 |