| NPI | 1821486093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN BAZLEY Managing Member 951-928-0494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2014-12-22 |