| NPI | 1720616360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARI LEWIS Owner/Administrator 951-430-1921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |