| NPI | 1972029486 |
|---|---|
| Other Name | FERN HOME 1 |
| Entity Type | Organization |
| Authorized Contact | JOI MAE GUBALANE Licensee/Administrator 310-997-8204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: CA 331800142) |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2022-07-21 |