| 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 |