Individual
MISS WANDA ELAINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
1046 E LANCASTER BLVD, LANCASTER, CA 93535-2752
(661) 992-6371
(855) 631-0360
Mailing address
1046 E. LANCASTER BLVD, LANCASTER, CA 93535
(661) 992-6371
(855) 631-0360
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
197602356
CA
Other
Enumeration date
12/11/2013
Last updated
08/16/2021
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