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Organization
MARY KRYSTAL HOME LLC
Active
Organization
MARY KRYSTAL HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONORA TOLEDO PULLIN PHARMACY TECH (ADMINISTRATOR)
(619) 267-3625
Entity
Organization
Contact information
Practice address
2361 MONTCLIFF RD, SAN DIEGO, CA 92139-3914
(619) 267-3625
Mailing address
2361 MONTCLIFF RD, SAN DIEGO, CA 92139-3914
(619) 267-3625
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
374602747
CA
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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