Organization
MARCEE LYNN HIRST
Active
Other names
Bentley House
Organization subpart
No
Provider details
NPI number
Authorized official
GREG HIRST (OWNER)
(951) 789-9698
Entity
Organization
Contact information
Practice address
11350 BENTLEY ST, RIVERSIDE, CA 92505-2257
(951) 789-9698
Mailing address
PO BOX 8175, RIVERSIDE, CA 92515-8175
(951) 789-9698
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
250000728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60864F
—
CA
Enumeration date
02/08/2007
Last updated
06/23/2008
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