| NPI | 1891784906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON GARREN Owner 209-473-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 100000288) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2020-08-22 |