# CORONA CONGREGATE CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467197103
- **Authorized official:** LESLEY SIHAVONG VANNOY (OWNER/CEO)
- **Authorized official phone:** (951) 847-5476

## Contact information

- **Practice address:** 7890 VANDEWATER ST, EASTVALE, CA 92880-5514
- **Practice address phone:** (951) 847-5476
- **Mailing address:** 7056 ARCHIBALD AVE \# 102-322, EASTVALE, CA 92880-8713
- **Mailing address phone:** (951) 847-5476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 04/27/2022
- **Last updated:** 04/27/2022