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Organization
QUEEN COMFORT CARE CENTER
Active
Organization
QUEEN COMFORT CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NINO GELASHVILL (OWNER)
(818) 370-2339
Entity
Organization
Contact information
Practice address
6534 MCLENNAN AVE, LAKE BALBOA, CA 91406-5543
(818) 616-1761
Mailing address
6534 MCLENNAN AVE, LAKE BALBOA, CA 91406-5543
(818) 616-1761
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
197608550
CA
Other
Enumeration date
07/12/2015
Last updated
07/12/2015
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