| NPI | 1649680810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA PONDER Office Administrator 951-315-1265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CA 9500567) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |