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Organization
PRIMARY RELIANCE INC
Active
Organization
PRIMARY RELIANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CELESTINE GREEN (OWNER)
(626) 966-1373
Entity
Organization
Contact information
Practice address
1342 PASEO ENCINAS, SAN DIMAS, CA 91773-4217
(909) 599-4396
Mailing address
226 N STEPHORA AVE, COVINA, CA 91724-3152
(626) 966-1373
(626) 915-1155
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60598F
ENCINAS PROVIDER NO.
CA
Enumeration date
03/19/2007
Last updated
08/22/2020
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