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Organization
GARDENA HOUSE
Active
Organization
GARDENA HOUSE
Active
Other names
VISTA PACIFICA ENTERPRISES,INC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL B JUMONVILLE (EXEC VICE PRESIDENT)
(951) 682-4833
Entity
Organization
Contact information
Practice address
1041 N GARDENA AVE, RIALTO, CA 92376-4214
(909) 874-7690
(909) 874-8689
Mailing address
3674 PACIFIC AVE, RIVERSIDE, CA 92509-1948
(951) 682-4833
(951) 682-1503
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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